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November 17, 1978

Peritoneal Dialysis in the Management of Hypothermia

Author Affiliations

From the Divisions of General Medicine (Dr Reuler) and Nephrology (Dr Parker), Department of Medicine, University of Oregon Health Sciences Center, Portland, and the Ambulatory Care and Medical Services, Portland Veterans Administration Hospital, Portland, Ore.

JAMA. 1978;240(21):2289-2290. doi:10.1001/jama.1978.03290210071037

PERITONEAL dialysis was introduced in 1923 as a treatment for acute and chronic renal failure. Since that time it has been useful for the management of congestive heart failure, drug intoxications, Reye's syndrome, hyaline membrane disease, hemorrhagic pancreatitis, and psoriasis. In 1967 Lash et al1 reported its use in the treatment of hypothermia. The technique is achieving widespread acceptance as a rewarming method of choice in the treatment of patients with severe, prolonged depression of body temperature.

Controversy Over Methods  In conjuction with general resuscitative measures in the treatment of the hypothermic patient, a mechanism for rewarming must be instituted.2 The potential for active external rewarming to aggravate the effect of hypothermia on core tissues has resulted in controversy over rewarming methods. The tendency for the core temperature to drop following removal of long-term cold stress may be exaggerated by peripheral vasodilation associated with external rewarming. Paradoxical central