In-theater peritoneal dialysis for combat-related renal failure
| Autor: | Soraya Moghadam, Vivian C. McAlister, Howard M. Cushner, Joseph S. Pina, Gregory J. Beilman |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
Operating Rooms medicine.medical_treatment Medical audit Treatment outcome Packaged Critical Care and Intensive Care Medicine Military medicine Kidney Failure Dialysis solutions Iraq War Dialysis Solutions Child Medical Audit Afghan Campaign 2001 Gunshot General Medicine Acute Kidney Injury humanities Hospitals Causality Military Personnel Transportation of Patients Treatment Outcome 2003 Wounds Level iii War Peritoneal Dialysis Adult medicine.medical_specialty Iraq war Warfare education Acute Peritoneal dialysis medicine Humans Renal replacement therapy Intensive care medicine Military Medicine Iraq War 2003-2011 Progressive Patient Care business.industry Hospitals Packaged Multiple Trauma Iraq War 2003 Kidney Failure Acute United States Surgery Wounds Gunshot business |
| Zdroj: | Surgery Publications Vivian C. McAlister |
| ISSN: | 1529-8809 |
| Popis: | BACKGROUND: Complications of renal failure may prevent timely evacuation of injured soldiers. Conventional renal replacement therapy is not available in forward surgical units. METHODS: Records of in-theater improvised peritoneal dialysis (IPD) in level III hospitals or forward surgical units in Iraq or Afghanistan were reviewed to determine the following: cause of renal failure and associated injuries; type of dialysate, peritoneal access, and exchange technique; and patient outcome. These data were used to propose method for IPD using commonly available materials. RESULTS: IPD is described in four patients. Abdominal or chest drains were used with either improvised dextrose-electrolyte solution or commercial dialysate. Exchanges were successful, despite fresh surgical wounds including full laparotomy, removed excess fluid and restored acid and electrolyte balance, but did not correct azotemia. Open abdominal packing prevented continuation of IPD after 48 hours. Two patients fully recovered, one died, and one patient with a poor prognosis was lost to follow-up. CONCLUSION: IPD can be delivered effectively using readily available materials in forward surgical units and level III combat support hospitals. |
| Databáze: | OpenAIRE |
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