Acute peritoneal dialysis in neonates: comparison of two types of peritoneal access.
A total of 23 sessions of peritoneal dialysis (PD) were given to 20 neonates with acute renal failure. Intravenous cannula (Biovalve 14G Vygon) was used for PD access in 13 procedures and guide wire-inserted femoral vein catheter (Medcomp-pediatric) in 10 procedures. Intraperitoneal bleed was seen in 1 procedure each in both groups. Dialysate leak and catheter blockade were more common with intravenous cannula [3 (23.1%), 8 (61.5%)] than guide wire-inserted femoral vein catheter [1 (10%), 4 (40%), P-NS]. Due to repeated catheter blockade, 5 (38.4%) PD sessions could not be completed with intravenous cannula and had to be prematurely closed; this complication was not seen with guide wire-inserted femoral vein catheter (P<0.05). Percentage reduction of serum creatinine per PD session was significantly higher in neonates being dialyzed with guide wire-inserted femoral vein catheter (51.7%+/-8.5%) than those dialyzed with intravenous cannula (38.3%+/-5.2%). Incidence of peritonitis was not significantly different [2 (15.4%) vs. 1 (10%)]. To conclude, for an effective PD in neonates, guide wire-inserted femoral vein catheter is safe and is associated with fewer access-related problems.