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Assessing the Feasibility of Right Atrial Line Removal at Hospital Discharge
Pilar Anton-Martin1, John J Nigro2, Meredith Ray3
1Division of Anesthesiology and Critical Care Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Background:
Right atrial lines are routinely used postoperatively in pediatric cardiac patients, but data and guidelines on their optimal long-term use and removal remain limited.
Methods:
This was an observational retrospective cohort study to characterize the safety and feasibility of right atrial line removal at hospital discharge in pediatric cardiac patients between 2011 and 2018 at a tertiary children's hospital.
Results:
A total of 686 children had 804 right atrial line placements during cardiac surgeries. Median age and weight were 22 (interquartile range [IQR], 7-134) days and 3.6 (IQR, 3.1-5.3) kg. In this cohort, single ventricle physiology constituted 35.3%, and 38% underwent palliative procedures. Median line duration was 11 (IQR, 7-19) days, with a median interval between line removal and hospital discharge of 0 (IQR, 0-4) days. Most right atrial lines (61.4%) were safely removed on the day of discharge without complications, discharge delays, or readmissions. Single-ventricle physiology, shunts, and palliative surgeries did not impact this practice.
Conclusions:
The removal of right atrial lines at discharge seems to be feasible and safe in the postoperative care of pediatric cardiac patients, including those with single-ventricle physiology, shunts, and palliative surgeries. Prospective studies are warranted to further refine and optimize right atrial line removal practices.
