My name is Petra Janasova- I work as a station nurse in the Department of Pediatric Nephrology at the Motol University Hospital at the 2nd Medical Faculty of Charles University in Prague.In the care of our doctors and nurses, patients are also dependent on peritoneal dialysis. I have been trying for some time to find out if someone has ever developed a standard of care for a peritoneal catheter – I am interested in the procedure of catheter dressing, care for it since its introduction to the patient. In the Czech Republic, a similar standard of nursing care (guideline) does not yet exist. The information I found on the internet is very strict.Can I ask you for information about peritoneal catheter care as you practice it in your medical facility?Thank you very much.Mgr. Petra Janasova
ANSWEREDPetra Janasova answered April 19, 2021
581 views
3 answers
0 vote
 I have a patient with bilateral patent processus vaginalis which was accidentally discovered while performing urgent-start PD and the caregiver placed him in an upright position which led to scrotal edema. The finding was confirmed by CT peritoneography. He underwent bilateral inguinal herniorrhaphy and currently shifted to hemodialysis. Is it safe to resume PD 4 weeks post-surgery? When resuming PD, should I start low fill volumes and shorter dwell time? Can I placed him right away to CAPD? Thank you
ANSWEREDMARY ROSE BISQUERA answered April 19, 2021
99 views
1 answer
0 vote
 When connecting drain tubing to the PD catheter with a povidone iodine cap, is it necessary to soak the catheter connection or tip in antiseptic prior to connecting the tubing? Or is a no touch technique superior when the catheter has an antiseptic soaked cap? The latest Lippincott procedure instructs to soak the catheter tip in an antiseptic soaked gauze for 5 minutes before connecting the tubing. I understand cleaning the catheter with the cap still on prior to removing the cap and connecting to the tubing, but I can't find any rationale for doing this extra step of soaking the catheter tip.
ANSWEREDAngela N answered April 15, 2021
97 views
1 answer
0 vote
 I have a patient on Hemodialysis short term due to polymicrobial peritonitis requiring catheter removal. Patient is on maintenance warfarin but bridged over to Lovenox for insertion of new PD cath. Post op day 10 patient felt unwell, weak, SOB. Hemoglobin was 65 (INR 5.3) and patient was determined to have hemoperitoneum. CT has shown no active bleed and after 4 units PRBC's, hemoglobin has remained stable. Over a number of days we have drained a total of 3.5L blood from peritoneum through patients PD cath. Wondering if you have any recommendations. Should we be draining hemoperitoneum? When we determine it is fully drained is it ok to restart PD? Thank you.
ANSWEREDJENNIFER,H answered April 2, 2021
397 views
1 answer
0 vote
 I am trying to achieve a target of 1.7 for a PD patient who has Crohn's disease. Patient was a slow transporter back in 2010 ( was transplanted) but now upon return to PD is a fast transporter. Patient can only fill with 2L max. Currently is on Cycler for 5 cycles over nine hours – KT/V is 1.45. Patient does make urine last collection approximately 750ml and is on Lasix. I am thinking of keeping APD regimen the same but adding icodextrin for day dwell. Thank you.
ANSWEREDSue answered October 16, 2020
319 views
1 answer
0 vote
 With the recent outbreak of the coronavirus, I was asked by some of my colleagues on how to discard the PD effluent of patients suspected or confirmed infected? Since this is a novel virus, our knowledge is still limited. Reviewing our data on SARS virus, I did not come across in my readings of report that the virus is isolated in PD effluents. So is it safe to handle the PD effluent the same way as any infectious bodily fluid, which is to double flush it into the toilet or clinical sink?
ANSWEREDRose, B. answered February 19, 2020
919 views
2 answers
1 vote
 In the 2016 ISPD Peritonitis Recommendations Update on Prevention and Treatment on page 488 it is noted that the IP route is preferred unless there is also systemic sepsis. In case where IV antimicrobial therapy may be needed, what is a reasonable dose for imipenem/cilastatin ? This antimicrobial is not included in Table 6 on page 490. Ertapenem is but does not have Pseudomonal coverage. Possibly imipenem/cilastatin 500 mg IV q 12 is reasonable since ertapenem is listed at half of the normal dosing?Thanks for your time and consideration.
ANSWEREDAndrea C answered February 11, 2020
566 views
1 answer
1 vote
 When obtaining a fluid sample for culture, what process should be followed on disinfecting prior to collection of fluid?Do you recommend cleaning the tops of culture bottles with alcohol wipe prior to use? (similar to collecting blood cultures)Do you recommend cleaning sample port with only betadine or alcavis, or will alcohol wipe work as well? thank you!Is "clean catch" appropriate when collecting a sample? (pouring from drain bag into sterile urine cup)…– Just want to get this done the right way!
ANSWEREDGwen answered February 10, 2020
826 views
1 answer
0 vote