Measurement of hydrostatic intraperitoneal pressure: a useful tool for the improvement of dialysis dose prescription

• Published in: Pediatric nephrology (Berlin, West) Vol. 18; no. 10; pp. 976 - 980
• Main Authors: FISCHBACH, M, TERZIC, J, LAUGEL, V, ESCANDE, B, DANGELSER, Cl, HELMSTETTER, A
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01-10-2003; Springer Nature B.V
• Subjects: Abdomen; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Atmospheric pressure; Biological and medical sciences; Body mass index; Child; Dialysate; Dialysis Solutions - administration & dosage; Emergency and intensive care: renal failure. Dialysis management; Hemodialysis; Humans; Hydrostatic Pressure; Intensive care medicine; Kidney Failure, Chronic - therapy; Medical sciences; Models, Theoretical; Peritoneal dialysis; Peritoneal Dialysis - methods; Human; Kidney disease; Volumetric analysis; Urinary system disease; Treatment efficiency; Dialysate; Intraperitoneal pressure; Peritoneal dialysis; Fill volume; Intraperitoneal; Extrarenal dialysis; Sensitivity; Newborn; Measurement technique; Cohort study; Hydrostatic pressure; Renal failure; Complication; Children; Therapeutic protocol; Child
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-003-1199-9

The prescription of peritoneal dialysis should be individualized based on parameters of tolerance and adequacy. Determination of the intraperitoneal fill volume is essential for optimal patient care. Fill volume enhancement is a factor of exchange surface area recruitment: the wetted, contact peritoneal dialysis membrane. Nevertheless, fill volume enhancement can also lead to patient discomfort, with the potential risk of too high an intraperitoneal pressure (hernia, gastro-esophageal reflux). The perception of the individual patient is also a subjective parameter of fill volume tolerance assessment. In contrast, measurement of the hydrostatic intraperitoneal pressure (IPP, cmH(2)O) allows an objective approach to fill volume tolerance. From our clinical experience of more than 10 years of IPP measurements in child care, we can give a recommendation for normal values in children: less than 18 cm of water, usually between 5 and 15 cm, correlated to the intraperitoneal fill volume (naturally), but individually taking into account age, gender, "accustomization" and overall body mass index.