Case series of acute peritoneal dialysis in the prone position for acute kidney injury during the Covid-19 pandemic: Prone to complications?
| Autor: | Vikramjit Mukherjee, Richard Amerling, Nina J. Caplin, Qandeel H Soomro |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty ARDS medicine.medical_treatment Respiratory physiology Patient Positioning law.invention Peritoneal dialysis law Prone Position medicine Humans Renal replacement therapy Intensive care medicine Retrospective Studies business.industry Acute kidney injury COVID-19 General Medicine Acute Kidney Injury Middle Aged medicine.disease Intensive care unit Intensive Care Units Prone position Nephrology Breathing Female business Peritoneal Dialysis |
| Zdroj: | Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis. 41:328-332 |
| ISSN: | 1718-4304 0896-8608 |
| DOI: | 10.1177/0896860820983670 |
| Popis: | Patients with kidney failure and acute respiratory distress syndrome (ARDS) requiring prone position have not been candidates for peritoneal dialysis (PD) due to concern with increased intra-abdominal pressure, reduction in respiratory system compliance and risks of peritoneal fluid leaks. We describe our experience in delivering acute PD during the surge in Covid-19 acute kidney injury (AKI) in the subset of patients requiring prone positioning. All seven patients included in this report were admitted to the intensive care unit with SARS-CoV-2 infection leading to ARDS, AKI and multisystem organ failure. All required renal replacement therapy, and prone positioning to improve ventilation/perfusion mismatch. All seven were able to continue PD despite prone positioning without any detrimental effects on respiratory mechanics or the need to switch to a different modality. Fluid leakage was noted in 71% of patients, but mild and readily resolved. We were able to successfully implement acute PD in ventilator-dependent prone patients suffering from Covid-19-related AKI. This required a team effort and some modifications in the conventional PD prescription and delivery. |
| Databáze: | OpenAIRE |
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