Peritoneal dialysis in children after cardiopulmonary bypass

Abstract

The early institution of peritoneal dialysis in acute renal failure and low cardiac output after cardiac operations not only removes fluid, thus easing fluid restriction, but may also improve cardiopulmonary function.

Zero Mortality of Continuous Veno-venous Hemodiafiltration with PMMA Hemofilter after Pediatric Cardiac Surgery

“…The survival rate of 21%-70 % in infants with acute renal failure after cardiac surgery has been reported by several authors. [4][5][6][7] CVVH is still an uncommon treatment in my PICU with an incidence of approximately 1%-2% per year. In this cohort of 7 children requiring vasoactive dosages, such as dopamine and epinephrine, PMMA-CVVH achieved a surprisingly high survival rate.…”

Outcome of acute renal failure associated with cardiac surgery in infants

“…The objective in most patients is to interrupt the cycle of hydric retention, cardiac overload, and tissular edema (mainly pulmonary edema), which if not rapidly controlled may contribute to death. In several studies [1][2][3][4][5][6]14 , the frequency of dialysis ranged from 1.6% to 7.7% of the patients undergoing cardiotomy.…”

“…The use of peritoneal dialysis in children with acute renal failure following cardiac surgery has proved to be an effective and safe method of easy installation, requiring no special infrastructure and no specially or complexly trained staff (nothing different from that already existing in any intensive care unit) 1,2,4,6,14,15 . The use of rigid catheters resultad in a good evolution in our patients maintained in peritoneal dialysis for a short-term period.…”

“…These facts may be challenged either by clinical demonstration of this or by other studies 1,2,4,6,14 , or by data showing that in patients in shock peritoneal blood perfusion is not reduced enough to impair the efficacy of dialysis 23 .…”

Repercussões cardiorrespiratórias da diálise peritoneal em crianças graves

“…Revista Brasileira 25 relataram aumento da PAM e da pressão venosa central em crianças em pós-operatório de cirurgia cardí-aca. Os estudos de Bokariia e col. 24 e Zhovnir e col. 30 não identificaram repercussões do procedimento, verificando que após a DP houve melhora nos parâmetros hemodinâmicos e renais.…”