Peritoneal dialysis—mechanical innovations

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THE technic of intermittent peritoneal dialysis has been generally accepted1, 2 and is particularly suited to use in community hospitals where highly trained personnel and sophisticated dialysis equipment are not readily available. Simple and inexpensive modifications in the apparatus used for intermittent peritoneal dialysis at the Cleveland Clinic Hospital have achieved greater efficiency in nursing care and shortened the time required for a single treatment. The nurse is freed from the mechanical task of repeatedly clamping inflow and outflow tubings, and can devote full attention to other nursing duties.

At the Cleveland Clinic Hospital about 250 peritoneal dialyses are performed each year. From this experience, simple modifications of equipment and technic have evolved. The aim is to increase the nurse's skill in caring for the patient and to improve the technic for performing intermittent peritoneal dialysis in a busy intensive medical care unit. The same procedure is followed in all cases. Under local anesthesia, a specially designed metal trochar is advanced into the patient's peritoneal cavity, through which a No. 11 French plastic catheter is inserted into the most dependent portion of the peritoneal cavity. Two liters of dialyzing solution are infused and allowed to remain for a 30-minute period of equilibration. The fluids are then drained into the same bottles that had been placed on the floor beside the bed. A single dialysis usually comprises 24 such cycles.

Technical Problems

A study of the dialysis cycle reveals that the troublesome periods are near the end of the infusion of . . .



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