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Published on: November 10, 2023
The effect of sildenafil on pleural and peritoneal effusions after the TCPC operation
Tapio K Koski1, Pertti K Suominen1, Alireza Raissadati2,3
1Department of Anesthesia and Intensive Care, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
Insights
Sildenafil administration did not shorten drain removal times after the TCPC operation. However, it was linked to increased fluid balance in pediatric patients.
Area of Science:
- Pediatric surgery
- Cardiovascular surgery
- Pharmacology
Background:
- The study investigates the impact of sildenafil on recovery after the TCPC operation in children.
- The TCPC operation is a complex surgical procedure requiring drain management.
Purpose of the Study:
- To determine if sildenafil administration shortens the interval to drain removal post-TCPC operation.
- To assess the effect of sildenafil on fluid balance in pediatric patients undergoing TCPC surgery.
Main Methods:
- Retrospective review of 122 pediatric patients who underwent TCPC operation.
- Comparison of a sildenafil group (n=48) with a control group (n=60).
- Sildenafil administered pre-operatively or within 24 hours post-operation.
Main Results:
- No significant difference in time to drain removal between sildenafil and control groups (11 days median for both).
- Significantly higher positive fluid balance on postoperative day 1 in the sildenafil group (P=.001).
- Positive fluid balance emerged as a predictor for prolonged drain use.
Conclusions:
- Sildenafil administration did not reduce the time required for drain removal post-TCPC.
- Sildenafil use was associated with a higher positive fluid balance post-surgery.
- Further research may be needed to understand the implications of altered fluid balance.
Background:
We evaluated whether the administration of sildenafil in children undergoing the TCPC operation shortened the interval from the operation to the removal of the pleural and peritoneal drains.
Methods:
We retrospectively reviewed the data of 122 patients who had undergone the TCPC operation between 2004 and 2014. Patients were divided into two groups on the basis of their treatments. Sildenafil was orally administered pre-operatively in the morning of the procedure or within 24 hours after the TCPC operation to the sildenafil group (n = 48), which was compared to a control group (n = 60). Fourteen patients were excluded from the study.
Results:
The primary outcome measure was the time from the operation to the removal of the drains. The study groups had similar demographics. The median [interquartile range] time for the removal of drains (sildenafil group 11 [8-19] vs control group 11 [7-16] d, P = .532) was comparable between the groups. The median [interquartile range] fluid balance on the first post-operative day was significantly higher (P = .001) in the sildenafil group compared with controls (47 [12-103] vs 7 [-6-67] mL kg-1 ). The first post-operative day fluid balance was a significant predictor for a prolonged need for drains in the multivariate analysis.
Conclusions:
Sildenafil administration, pre-operatively or within 24 hours after the TCPC operation, did not reduce the required time for pleural and peritoneal drains but was associated with a significantly higher positive fluid balance.
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