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Peritoneal Dialysis Using a Bicarbonate-buffered Dialysate in a Child with an Inborn Error of Metabolism Presenting with Severe Acidosis.
Indian J Crit Care Med. 2020 Mar; 24(3):200-202.IJ

Abstract

Metabolic acidosis is observed in the pediatric intensive care unit (PICU) in several conditions including sepsis, intoxications, and severe catabolic states. It is occasionally seen due to acute decompensation in an inborn error of metabolism (IEM). Persistent acidosis results in a decrease in myocardial contractility, cardiac output, and catecholamine responsiveness. The mainstay of treatment of metabolic acidosis has been intravenous sodium bicarbonate infusion. However, the large amounts of sodium bicarbonate sometimes required can be hazardous resulting in hypernatremia, hypervolemia, and hyperosmolality. We report a 3-year child who presented with persistent lactic acidosis due to an IEM whom we treated with peritoneal dialysis (PD) using a bicarbonate-buffered dialysate. The child recovered uneventfully within 72 hours of dialysis. Peritoneal dialysis using a bicarbonate-buffered dialysate is a safe and simple method of treating persistent severe acidosis in the PICU. How to cite this article: Kalbhande A, Gajare U, Shanbag P. Peritoneal Dialysis Using a Bicarbonate-buffered Dialysate in a Child with an Inborn Error of Metabolism Presenting with Severe Acidosis. Indian J Crit Care Med 2020;24(3):200-202.

Authors+Show Affiliations

Department of Pediatrics, ESI-Postgraduate Institute of Medical Science and Research, Model Hospital, Mumbai, Maharashtra, India.Department of Pediatrics, ESI-Postgraduate Institute of Medical Science and Research, Model Hospital, Mumbai, Maharashtra, India.Department of Pediatrics, ESI-Postgraduate Institute of Medical Science and Research, Model Hospital, Mumbai, Maharashtra, India.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32435100

Citation

Kalbhande, Anjali, et al. "Peritoneal Dialysis Using a Bicarbonate-buffered Dialysate in a Child With an Inborn Error of Metabolism Presenting With Severe Acidosis." Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, vol. 24, no. 3, 2020, pp. 200-202.
Kalbhande A, Gajare U, Shanbag P. Peritoneal Dialysis Using a Bicarbonate-buffered Dialysate in a Child with an Inborn Error of Metabolism Presenting with Severe Acidosis. Indian J Crit Care Med. 2020;24(3):200-202.
Kalbhande, A., Gajare, U., & Shanbag, P. (2020). Peritoneal Dialysis Using a Bicarbonate-buffered Dialysate in a Child with an Inborn Error of Metabolism Presenting with Severe Acidosis. Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 24(3), 200-202. https://doi.org/10.5005/jp-journals-10071-23372
Kalbhande A, Gajare U, Shanbag P. Peritoneal Dialysis Using a Bicarbonate-buffered Dialysate in a Child With an Inborn Error of Metabolism Presenting With Severe Acidosis. Indian J Crit Care Med. 2020;24(3):200-202. PubMed PMID: 32435100.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Peritoneal Dialysis Using a Bicarbonate-buffered Dialysate in a Child with an Inborn Error of Metabolism Presenting with Severe Acidosis. AU - Kalbhande,Anjali, AU - Gajare,Uday, AU - Shanbag,Preeti, PY - 2020/5/22/entrez PY - 2020/5/22/pubmed PY - 2020/5/22/medline KW - Acute peritoneal dialysis KW - Bicarbonate-buffered dialysate KW - Inborn error of metabolism KW - Severe acidosis SP - 200 EP - 202 JF - Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine JO - Indian J Crit Care Med VL - 24 IS - 3 N2 - Metabolic acidosis is observed in the pediatric intensive care unit (PICU) in several conditions including sepsis, intoxications, and severe catabolic states. It is occasionally seen due to acute decompensation in an inborn error of metabolism (IEM). Persistent acidosis results in a decrease in myocardial contractility, cardiac output, and catecholamine responsiveness. The mainstay of treatment of metabolic acidosis has been intravenous sodium bicarbonate infusion. However, the large amounts of sodium bicarbonate sometimes required can be hazardous resulting in hypernatremia, hypervolemia, and hyperosmolality. We report a 3-year child who presented with persistent lactic acidosis due to an IEM whom we treated with peritoneal dialysis (PD) using a bicarbonate-buffered dialysate. The child recovered uneventfully within 72 hours of dialysis. Peritoneal dialysis using a bicarbonate-buffered dialysate is a safe and simple method of treating persistent severe acidosis in the PICU. How to cite this article: Kalbhande A, Gajare U, Shanbag P. Peritoneal Dialysis Using a Bicarbonate-buffered Dialysate in a Child with an Inborn Error of Metabolism Presenting with Severe Acidosis. Indian J Crit Care Med 2020;24(3):200-202. SN - 0972-5229 UR - https://www.unboundmedicine.com/medline/citation/32435100/Peritoneal_Dialysis_Using_a_Bicarbonate-buffered_Dialysate_in_a_Child_with_an_Inborn_Error_of_Metabolism_Presenting_with_Severe_Acidosis DB - PRIME DP - Unbound Medicine ER -
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