A case of a neonate with multiple organ failure treated by bicarbonate-buffered peritoneal dialysis

Abstract

We report a case of a neonate with multiple organ failure treated by bicarbonate-buffered peritoneal dialysis (PD). The newborn suffered from respiratory and circulatory failure, and was intubated and ventilated immediately. However, she did not recover from hypoxia and hypotension, and subsequently developed severe lactic acidosis, hepatic dysfunction, acute renal failure, and disseminated intravascular coagulation. She was admitted to ICU for the treatment of PD at two days after birth. PD was performed for twenty hours, but her blood lactate level remained high and circulation was unstable. Therefore, we decided to switch from lactate-buffered solution to bicarbonate-buffered solution. After the switch, the blood lactate level fell to normal, and clinical condition was improved. On the 4th ICU day, urine output increased, and on the 6th day, PD was discontinued. On the 12th day, she was weaned from the ventilator. We believe that the bicarbonate-buffered PD was effective in treating the refractory lactic acidosis and improved the overall general condition.