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Peritoneal dialysis after infant open heart surgery: observations in 27 patients
S Dittrich1, I Dähnert, M Vogel
1Department of Congenital Heart Disease, German Heart Center Berlin. svsdittr@aol.com
Insights
Peritoneal dialysis (PD) effectively manages fluid balance and acute renal failure (ARF) in infants after heart surgery. Prophylactic PD is recommended for high-risk infants to improve outcomes.
Area of Science:
- Pediatric Cardiology
- Nephrology
- Critical Care Medicine
Background:
- The use of peritoneal dialysis (PD) in infants following heart operations is debated.
- This study evaluates PD's impact on fluid balance and patient outcomes.
Purpose of the Study:
- To investigate the efficacy and safety of peritoneal dialysis (PD) in infants after heart surgery.
- To assess PD's effect on fluid balance and outcomes in this patient population.
Main Methods:
- Retrospective analysis of 81 infants undergoing heart operations, with 27 requiring PD.
- Hemodynamic data and fluid balance were recorded.
- Infants with acute renal failure (ARF) were compared to those without.
Main Results:
- 14% of infants developed ARF; mortality was 4% overall and 27% in ARF cases.
- PD complications were minor and transient (33%).
- ARF patients had poorer cardiac function but similar fluid balance compared to non-ARF patients.
Conclusions:
- Peritoneal dialysis is a safe and effective treatment for ARF in infants post-heart operation.
- PD aids in managing postoperative fluid balance.
- Prophylactic PD is advisable for select infants at risk of low cardiac output syndrome.
Background:
The role of peritoneal dialysis (PD) in the management of infants after heart operation is under discussion. The aim of this study was to investigate the effect of PD on fluid balance and outcome.
Methods:
Twenty-seven (33%) of 81 consecutive infants who underwent heart operation required PD. In 22 patients (81%), PD was started prophylactically at the end of the operation. We recorded hemodynamic data and fluid balance. Patients experiencing acute renal failure (ARF) were compared with the remaining infants.
Results:
Eleven of 81 patients (14%) experienced ARF; 3 of them died (4% of all patients undergoing operation, 27% of those with ARF). Complications of PD, present in 33%, were transitory and of minor significance. Patients with ARF had decreased cardiac function compared with those without ARF but similar fluid balance.
Conclusions:
Peritoneal dialysis is an effective and safe method for the treatment of ARF in infants after open heart operation. As PD is helpful in modulating postoperative fluid balance, prophylactic use of PD can be recommended for selected patients who are at risk for low cardiac output syndrome.