Evaluation of intraperitoneal pressure and the effect of different osmotic agents on intraperitoneal pressure in children.
OBJECTIVE
To establish intraperitoneal pressure (IPP) in a relatively large pediatric study group and to study the effects of a 3.86% glucose solution and a 7.5% icodextrin solution on IPP during a 4-hour dwell.


METHODS
IPP was measured with the patient in a supine position. The intraperitoneal volume (IPV) was 1200 mL/m2 with a 1.36% glucose solution. The influence of dialysis solutions was obtained by performing two 4-hour peritoneal equilibration tests (PETs) with 3.86% glucose and 7.5% icodextrin as test solution, using an IPV of 1200 mL/m2 and dextran 70 as volume marker. IPP was measured at two consecutive time points (t = 0 and t = 240 minutes). Transcapillary ultrafiltration, net ultrafiltration, and marker clearance were calculated.


METHODS
IPP was established in 30 patients with median age of 4.5 years (range 1.0 - 14.9 years). Influence of dialysis solutions on IPP was studied in 9 children with median age of 4.2 years (range 1.7 - 10.9 years) and median treatment period of 12 months (range 5.6 - 122.3 months).


RESULTS
Mean IPP was 12.0 +/- 6.5 cm H2O. Significant relations were found between the change in IPP and transcapillary ultrafiltration and body surface area during the PET with 3.86% glucose. No relations were seen during the PET with icodextrin.


CONCLUSIONS
IPP was established in a large pediatric study group and was similar to previously published values of IPP in a small number of patients. Differences in fluid kinetics have different effects on the change in IPP during a 4-hour dwell period.
Rusthoven
Esther
E
Department of Pediatric Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands. erusthoven@xs4all.nl
van der Vlugt
Maartje E
ME
van Lingen-van Bueren
Lida J
LJ
van Schaijk
Theodora C J G
TC
Willems
Hans L
HL
Monnens
Leo A H
LA
Schröder
Cornelis H
CH
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015314:Dialysis Solutions / Q000493:pharmacokinetics*; D005260:Female; D005500:Follow-Up Studies; D005936:Glucans / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005947:Glucose / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005950:Glucose Solution, Hypertonic / Q000493:pharmacokinetics*; D006801:Humans; D000077607:Icodextrin; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D009995:Osmosis / Q000502:physiology; D010529:Peritoneal Cavity / Q000502:physiology*; D010530:Peritoneal Dialysis / Q000379:methods*; D011312:Pressure
D015314:Dialysis Solutions; D005936:Glucans; D005950:Glucose Solution, Hypertonic; D000077607:Icodextrin; D005947:Glucose