The Performance of Acute Peritoneal Dialysis Treatment in Neonatal Period

Abstract

The aim of this retrospective study was to evaluate our neonatal intensive care unit (NICU) patients' characteristics treated with acute peritoneal dialysis (PD) and their risk factors for mortality. We also wanted to share our experience of the application of PD in neonates who required less than 60 mL of dwell volume and their PD-related problems, as well as special solutions for these problems. This study included 27 infants treated in our NICU between February 2008 and December 2011. We retrospectively analyzed these patients' records. The percutaneous PD catheter was placed by us. PD procedure was performed either by manual technique or automated PD. Statistical evaluation was performed by using χ(2)-tests and Student's t-tests. In these 27 neonates, the average gestational age and birth weight were 35.18 ± 4.02 weeks and 2534.62 ± 897.41 g, respectively. The mean PD duration time was 6.11 ± 6.30 days. Of these, 10 patients were treated by manual technique, whereas 17 patients were treated with automated system. Among 27 neonates, 16 patients died. Overall mortality rate was 59.25%. PD-related complications were seen in 25.92% of patients. In conclusion, PD application is less effective and troublesome for low-birth-weight infants. Each center should create its own solutions to accommodate problematic patients in PD treatment to improve the outcome in this special population.

Intra‐hospital mortality among neonates transported by ambulance in Colombia

“…This may be due to differences in the studies' sample sizes. 15 Other studies have reported that renal damage 16,17 and congenital defects 18 are associated with mortality; the latter is the second cause of neonatal mortality in developed countries. The intervention of the health team should improve the prognostics for these illnesses and, therefore, early treatment, optimized transport time and an Intra-hospital mortality among neonates 573 interdisciplinary (prenatal) approach can improve outcome for these patients.…”

Neonatal Acute Kidney Injury

“…90 If peritoneal dialysis is felt to be a short-term requirement, a temporary catheter can be placed. Several studies describe successful peritoneal dialysis by several different techniques in critically ill neonates as small as 830 g. [91][92][93][94][95] When PD is technically difficult because of abdominal wall defects, skin infections, communication to the pleural space, or high ultrafiltration needs, CRRT can be performed. CRRT is performed with a hemodialysis catheter placed in a central location and either regional or systemic anticoagulation.…”

Effect of Peritoneal Dialysis on Extremely Low Birth Weight Infants: A Retrospective Cohort Study

“…Over the years, PD has become an effective and increasingly popular alternative to HD in the management of critically ill neonates, including premature infants [9,25]. PD has been relatively safe, technically simple, and cost-effective.…”

“…PD has been relatively safe, technically simple, and cost-effective. It can also be applied in hemodynamically unstable premature infants [2,8,12,25]. The catheter design, implantation site, and system configuration used to perform dialysis determine the effectiveness of PD in premature infants.…”

“…The severe complication of PD was peritonitis, and only one patient developed such in this study. The use of prophylactic antibiotics should be carefully considered with advantages of infection prevention and disadvantages of antibiotic-resistant bacterial generation [25,28]. The efficacy of PD in ELBW infants is affected by many factors.…”