Hydrostatic intraperitoneal pressure in children on peritoneal dialysis: practical implications. An 18-month clinical experience.
Intraperitoneal pressure (IPP) is easy to measure routinely in children on peritoneal dialysis (PD) (especially with the twin bag Y-set) as described in adults: value expressed in centimeters of water, average of IPP (mean IPP) at inspiration and at expiration, with point zero located on the mid-axillary line while the patient rests in a perfectly supine position. IPP remained high during the first two to three days postsurgical peritoneal catheter implantation (15 +/- 4 cm) despite low dialysate volume per exchange (10 mL/kg). Afterwards, IPP decreased (10 +/- 2 cm) despite increasing dialysate volume from 10-50 mL/kg. Mean IPP seemed lower in infants (5 +/- 3 cm) in contrast to children (10 +/- 2 cm) on chronic PD with dialysate volume of 1000 mL/m2. There was a strong negative linear correlation between ultrafiltration (UF) volume and mean IPP with isotonic dialysate (1.36% dextrose concentration). By contrast, there was only a weak positive linear correlation between UF volume and mean IPP with hypertonic dialysate (3.86% dextrose concentration).
Fischbach
M
M
Nephrology Dialysis Transplantation Children's Unit, Strasbourg, France.
Desprez
P
P
Donnars
F
F
Geisert
J
J
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006874:Hydrostatic Pressure; D007223:Infant; D010529:Peritoneal Cavity / Q000503:physiopathology*; D010530:Peritoneal Dialysis; D014462:Ultrafiltration