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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Published on: July 19, 2018

Use of a soft catheter for acute peritoneal dialysis in infants and children

C L Abitbol, J Partin, S Katz

    The International Journal of Pediatric Nephrology
    |April 1, 1986
    PubMed

    Insights

    For infants undergoing acute peritoneal dialysis, soft catheters significantly reduce major complications compared to hard Trocath catheters. This study recommends soft catheters for neonates and older children to improve safety during dialysis.

    Area of Science:

    • Pediatric Nephrology
    • Critical Care Medicine
    • Medical Device Technology

    Background:

    • Acute peritoneal dialysis is a vital treatment for infants and children with kidney failure.
    • Catheter choice in peritoneal dialysis can influence complication rates and patient outcomes.
    • The Trocath catheter is a conventional hard catheter, while soft catheters offer an alternative.

    Purpose of the Study:

    • To compare the safety and efficacy of conventional hard Trocath catheters versus soft catheters for acute peritoneal dialysis in pediatric patients.
    • To identify specific complications associated with each catheter type in different age groups.
    • To provide evidence-based recommendations for catheter selection in neonatal and pediatric acute peritoneal dialysis.

    Main Methods:

    • Retrospective analysis of 49 infants and children undergoing acute peritoneal dialysis.
    • Comparison of outcomes between patients treated with hard Trocath catheters (n=16) and soft catheters (n=33).
    • Data collection on mortality, major complications (viscus perforation, dialysate extravasation), and peritonitis.

    Main Results:

    • Overall mortality was 43%; neonates (23) had a higher mortality (61%) than older children (26) (31%).
    • Major complications, including viscus perforation and dialysate extravasation, occurred exclusively with the hard Trocath catheter in neonates and older patients.
    • Peritonitis occurred in two patients and was not linked to catheter type but rather to sterile system breaches.

    Conclusions:

    • The hard Trocath catheter is associated with significant major complications in neonates, precluding its use in this population.
    • Soft catheters are recommended for acute peritoneal dialysis in neonates.
    • Elective use of soft catheters is also indicated for older pediatric patients undergoing acute peritoneal dialysis to enhance safety.

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