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07:11
Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
Published on: July 19, 2018
In-theater peritoneal dialysis for combat-related renal failure.
Joseph S Pina1, Soraya Moghadam, Howard M Cushner
1United States Army Pacific, , Madigan Army Medical Center, Tacoma, Washington, USA.
The Journal of Trauma
|May 11, 2010
Summary
Improvised peritoneal dialysis (IPD) offers a viable solution for renal failure in deployed settings. This method effectively manages fluid and electrolyte balance in soldiers when conventional treatments are unavailable.
Area of Science:
- Military Medicine
- Nephrology
- Surgical Critical Care
Background:
- Renal failure complications can impede soldier evacuation.
- Standard renal replacement therapy is inaccessible in forward surgical units.
Observation:
- Reviewed in-theater improvised peritoneal dialysis (IPD) in combat hospitals.
- Analyzed dialysate, access, technique, and outcomes in four patients.
- Utilized abdominal/chest drains with improvised or commercial dialysate.
Findings:
- IPD successfully removed excess fluid and corrected acid-base/electrolyte imbalances.
- Azotemia was not corrected; open abdominal packing limited IPD to 48 hours.
- Two patients recovered, one died, and one was lost to follow-up.
Implications:
- IPD is feasible in forward surgical units using available materials.
- This technique can support critically injured soldiers with renal failure.
- Further research may optimize IPD for combat casualty care.
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