GASTRODIALYSIS IN THE TREATMENT OF ACUTE RENAL FAILURE*†

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Abstract
Previous attempts to use gastric lavage or gastrodialysis in the treatment of patients failed because of uncontrollable electrolyte transfers and loss of large amounts of dialysis fluid into the patients. These problems were largely solved by the cellophane bag technique of gastrodialysis. Fluid was cycled at body temperature through the cellophane bag. A timing clock rotates a cam which operates switches controlling solenoid values and electric pumps that cycle the fluid in and out of the bag. A safety switch stops the cycling process if excessive fluid losses occur, thus permitting operation of the apparatus without constant supervision. The effects of gastrodialysis were studied in 14 patients with acute renal insufficiency. The most rapid transfers affect the acid-base status of the patient. Large chloride-bicarbonate transfers were made. Hydrogen-sodium transfers were smaller. Potassium removal varied from 6 to 50 mEq./24 hours and averaged 25 mEq. With isotonic solutions, no transfer of water has occurred, whereas hypertonic solutions of 20-40% glucose removed up to 1 1/24 hours. Nitrogen removal ranged from 0.6 to 5.6 g/24 hours and averaged 2.5 g. Glucose transfers varied with the concentration of glucose (from 100 to 800 g were given by this means).