USED IN RENALCIDIN IRRIGATION SOLUTION FOR DISSOLUTION OF RENAL STONES:
FOR POSTOPERATIVE PATIENTS IRRIGATION SHOULD NOT BE STARTED BEFORE THE FOURTH OR FIFTH POSTOPERATIVE DAY. IRRIGATION OF THE RENAL PELVIS IS BEGUN WITH STERILE SALINE ONLY AFTER A STERILE URINE HAS BEEN DEMONSTRATED. THE SALINE IS INFUSED AT A RATE OF 60 ML/HR INITIALLY AND THE RATE IS INCREASED UNTIL PAIN OR AN ELEVATED PRESSURE (25 CM 1120) APPEARS, OR UNTIL A MAXIMUM FLOW-RATE OF 120 ML/HR IS ACHIEVED. THE SITE OF INSERTION SHOULD BE INSPECTED FOR LEAKAGE. IF LEAKAGE OCCURS, THE IRRIGATION IS DISCONTINUED TEMPORARILY TO ALLOW FOR COMPLETE HEALING AROUND THE NEPHROSTOMY TUBE.
IF NO LEAKAGE OR FLANK PAIN OCCURS, IRRIGATION IS THEN STARTED WITH RENACIDIN IRRIGATION WITH A FLOW RATE EQUAL TO THE MAXIMUM RATE ACHIEVED WITH THE SALINE SOLUTION. A CLAMP SHOULD BE PLACED ON THE INFLOW TUBE AND PATIENTS AND NURSING PERSONNEL SHOULD BE INSTRUCTED TO STOP THE IRRIGATING SOLUTION WHENEVER PAIN DEVELOPS. NURSING PERSONNEL WHO ARE RESPONSIBLE FOR PERFORMING THE IRRIGATION MUST BE INSTRUCTED CONCERNING THE LOCATION OF THE NEPHROSTOMY TUBE(S) AND THE DIRECTION OF FLOW OF THE IRRIGATING SOLUTION TO INSURE AGAINST MISCONNECTION OF THE INFLOWING AND EGRESS TUBES. NEPHROSTOMOGRAMS SHOULD BE PERFORMED PERIODICALLY TO ASSURE PROPER PLACEMENT OF THE CATHETER TIP AND TO ASSESS EFFICACY. IF STONES FAIL TO CHANGE SIZE AFTER SEVERAL DAYS OF ADEQUATE IRRIGATION THE PROCEDURE SHOULD BE DISCONTINUED.