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Updated: Jul 26, 2025

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Peritoneal catheters in neonates undergoing complex cardiac surgery: a multi-centre descriptive study.

David M Kwiatkowski1, Jeffrey A Alten2, Tia T Raymond3

  • 1Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.

Cardiology in the Young
|June 20, 2023
PubMed
Summary

Peritoneal catheter use after neonatal cardiac surgery varies widely among centers. This study found no difference in adverse events, fluid overload, or acute kidney injury in neonates receiving peritoneal catheters for dialysis or drainage.

Keywords:
Acute kidney injuryFluid overloadNeonatal cardiac surgeryPeritoneal catheterPeritoneal dialysis

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Area of Science:

  • Neonatal surgery
  • Pediatric nephrology
  • Cardiology

Background:

  • Peritoneal catheters are used for dialysis or drainage post-neonatal cardiac surgery to manage fluid overload.
  • However, multi-center variability and specific usage details are not well-documented.

Purpose of the Study:

  • To describe multi-center peritoneal catheter use in neonates undergoing complex cardiac surgery.
  • To analyze patient characteristics and outcomes (acute kidney injury, fluid balance) associated with catheter use.

Main Methods:

  • A 22-center study (NEPHRON) analyzed data from 1490 neonates undergoing STAT category 3-5 cardiac surgery with cardiopulmonary bypass.
  • Patients were categorized into three groups: peritoneal catheter with dialysis, peritoneal catheter with passive drainage, and no catheter.
  • Outcomes were assessed for six post-operative days.

Main Results:

  • 32% of neonates received an intraoperative peritoneal catheter (12% dialysis, 20% drainage).
  • Catheter use varied significantly across centers, with some using them in over 50% of neonates.
  • No significant differences were observed in serum creatinine, fluid balance, adverse events, or mortality between groups.

Conclusions:

  • Peritoneal catheter use is common but highly variable in neonates undergoing complex cardiac surgery.
  • Catheter use is associated with higher surgical complexity but not increased adverse events or mortality.
  • Fluid overload and acute kidney injury rates were similar regardless of peritoneal catheter use.