Related Experiment Video
Updated: May 17, 2026
A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
Published on: July 20, 2022
Characterizing peritoneal dialysis catheter use in pediatric patients after cardiac surgery
Arin L Madenci1, Ravi R Thiagarajan, Alexander P Stoffan
1University of Mich Medical School, Ann Arbor, Mich, USA.
Insights
Peritoneal dialysis catheter (PDC) use in pediatric cardiac surgery patients is associated with high mortality, even after accounting for acute renal failure. Further research is needed to determine the benefits of earlier peritoneal access in this high-risk group.
Area of Science:
- Pediatric Cardiac Surgery
- Nephrology
- Critical Care Medicine
Background:
- Children undergoing cardiac surgery face significant risks of renal insufficiency and abdominal compartment syndrome.
- Peritoneal dialysis catheters (PDCs) are used for decompression and dialysis access in these patients, but their application lacks consensus and varies widely.
- This study addresses the variability and outcomes associated with PDC use in pediatric cardiac surgery patients.
Purpose of the Study:
- To assess factors associated with Peritoneal Dialysis Catheter (PDC) implantation in pediatric cardiac surgery patients.
- To evaluate the outcomes, including mortality, associated with PDC use in this population.
- To examine the variability in PDC utilization following pediatric cardiac surgery.
Main Methods:
- A retrospective cohort analysis using the Kids' Inpatient Database (2006 and 2009).
- Inclusion of patients who underwent cardiac surgery and subsequent PDC implantation during the same hospitalization.
- Application of univariable and multivariable analyses to identify factors associated with PDC placement and patient survival.
Main Results:
- Out of 28,259 pediatric cardiac surgery patients, 2% (n=558) received a PDC.
- The PDC group showed higher rates of acute renal failure (39.1%) compared to the non-PDC group (3.5%).
- Mortality was significantly higher in the PDC group (20.3%) versus the overall cohort (3.4%), remaining 12% even after excluding patients with acute renal failure.
Conclusions:
- Peritoneal dialysis catheter use in pediatric cardiac surgery patients is linked to a substantial mortality rate (20.3%), which persists at 12% when excluding acute renal failure.
- Significant variability exists in PDC use, coupled with poor outcomes, underscoring the need for further investigation.
- Research is warranted to explore the potential benefits of earlier peritoneal access interventions for this vulnerable patient population.
Objective:
Children who undergo cardiac surgery are at high risk for renal insufficiency and abdominal compartment syndrome. Peritoneal dialysis catheter (PDC) implantation is used in this population for abdominal decompression and access for dialysis. However, there is no consensus regarding PDC use, and the practice varies widely. This study was undertaken to assess associated factors, outcomes, and variability in the use of PDC in patients who have undergone cardiac surgery.
Methods:
The cohort was obtained from the Kids' Inpatient Database, years 2006 and 2009. Patients who underwent cardiac surgery were included and the subset that underwent PDC implantation during the same hospitalization was identified. Univariable and multivariable analyses assessed factors associated with PDC and survival.
Results:
A cohort of 28,259 patients underwent cardiac surgery, of whom 558 (2%) had PDCs placed. In the PDC group, 39.1% (n = 218) had acute renal failure whereas 3.5% or patients (n = 974) in the non-PDC group had acute renal failure. Among patients receiving PDC, mortality was 20.3% (n = 113; vs 3.4% overall mortality, n = 955). Excluding patients with acute renal failure, mortality remained 12% (n = 41) for the PDC group. Factors associated significantly with PDC placement in the overall cohort were younger age, greater surgical complexity, nonelective admission, hospital region, use of cardiopulmonary bypass, and acute renal failure.
Conclusions:
Patients receiving PDC after cardiac surgery had 20% mortality, which remained 12% after excluding patients with acute renal failure. Given the variability in PDC use and poor outcomes, further research is needed to assess the possible benefit of earlier intervention for peritoneal access in this high-risk cohort.
Related Concept Videos
01:30Peritoneal Dialysis I: Introduction and Procedure
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:26Cardiac Catheterization IV: Nursing Management
01:25Peritoneal Dialysis III: Nursing Management
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...