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The Use of Intraperitoneal Infusion for the Outpatient Treatment of Hypovolemia in Somalia

Published online by Cambridge University Press:  28 June 2012

Michael J. VanRooyen ,
Julia B. VanRooyen  and
Edward P. Sloan
Michael J. VanRooyen*
Affiliation:
Department of Emergency Medicine, Office of International Studies University of Illinois College of Medicine, Chicago, Illinois
Julia B. VanRooyen
Affiliation:
Department of Emergency Medicine, Office of International Studies University of Illinois College of Medicine, Chicago, Illinois
Edward P. Sloan
Affiliation:
Department of Emergency Medicine, Office of International Studies University of Illinois College of Medicine, Chicago, Illinois
*
University of Illinois College of Medicine, Program in Emergency Medicine, Room 618, M/C 724, 1853 W. Polk Street, Chicago, IL 60612USA
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Abstract

Introduction:

The civil war in Somalia has destroyed the medical system and left hundreds of thousands of people without access to medical care. Samaritan's Purse and World Medical Missions, two relief organizations, developed mobile medical teams to provide health care to urban and rural Somalia. Gastroenteritis with severe dehydration was encountered frequently, and difficult intravenous (TV) access presented a challenging dilemma for patients who were unable to tolerate oral or nasogastric fluid administration.

Hypothesis:

Intraperitoneal (IV) fluid infusion may be used to treat dehydration in patients with poor venous access and ongoing fluid losses.

Methods:

Two mobile medical teams treated patients from 1 January to 1 April 1993. Intraperitoneal fluid infusions were given to 16 patients with severe dehydration in whom IV access was unobtainable. Children received approximately 80 ml/kg of 0.45% normal saline, and adults received 40 ml/kg of 0.9% normal saline. Patients were reexamined at one and seven days.

Results:

A total of 25,659 patients were seen in the mobile medical clinics during a 3-month period. Dehydration was diagnosed in 1,833 (7.1%) patients, and 1,203 (4.7%) patients were found to be malnourished. Sixteen patients were treated with IP fluid infusions, 14 patients (87.5%) survived, and two patients (12.5%) died, both within 24 hours. In one patient (6.3%), subcutaneous infiltration occurred without subsequent adverse effects.

Conclusion:

This case series found that in the mobile clinic setting in Somalia, IP fluid administration improved the hydration status in patients with significant dehydration. Although IV infusion remains the treatment of choice when oral or nasogastric fluid administration is not possible, IP infusion is easily performed and may be an important alternative in disaster setting.

Keywords

dehydrationdisasterhypovolemiaintraperitonealmalnutritionrefugeerehydrationSomaliawar
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 10 , Issue 1 , March 1995 , pp. 57 - 59
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1995

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