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Case series of acute peritoneal dialysis in the prone position for acute kidney injury during the Covid-19 pandemic: Prone to complications?
Soomro, Qandeel H; Mukherjee, Vikramjit; Amerling, Richard; Caplin, Nina.
  • Soomro QH; Nephrology Division, Department of Medicine, NYU Langone Medical Center, New York, NY, USA.
  • Mukherjee V; Division of Pulmonary Disease and Critical Care Medicine, Department of Medicine, Bellevue Hospital Center and 12297NYU Langone Health, New York, NY, USA.
  • Amerling R; St. George's University School of Medicine, Grenada, West Indies.
  • Caplin N; Nephrology Division, Department of Medicine, NYU Langone Medical Center, New York, NY, USA.
Perit Dial Int ; 41(3): 328-332, 2021 05.
Article in English | MEDLINE | ID: covidwho-1013120
ABSTRACT
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Peritoneal Dialysis / Prone Position / Patient Positioning / Acute Kidney Injury / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Perit Dial Int Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: 0896860820983670

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Peritoneal Dialysis / Prone Position / Patient Positioning / Acute Kidney Injury / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Perit Dial Int Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: 0896860820983670