Peritoneal Dialysis in Pediatric Postoperative Cardiac Surgical Patients

Abstract

Background We determined the prevalence of acute kidney injury requiring peritoneal dialysis (PD), the factors associated with early PD initiation, prolonged PD and mortality among pediatric postoperative cardiac surgical patients. Materials and Methods The hospital records of 23 children, aged 12 years or younger, who had undergone cardiac surgery and required PD subsequently, during a 1-year period were reviewed. Demographic data, intraoperative variables, and postoperative complications were compared between survivors and nonsurvivors of PD, between the short and long duration PD groups, and between the early and late PD initiation groups. Results Six hundred and eight pediatric patients who underwent open heart surgery were enrolled in this study. 23 (3.78%) of them required PD. When compared with survivors ( n = 11), non survivors ( n =12) were more likely to have a higher serum procalcitonin ( p = 0.01), higher serum potassium on day 2 ( p = 0.001), day 3 ( p = 0.04), day of termination of PD ( p = 0.001) and a lower urine output on day 3 of PD ( p = 0.03). Prolonged PD was associated with time of PD initiation ( p = 0.01), a higher postoperative serum creatinine on day 3 ( p = 0.01) of PD initiation as well on the day of PD termination ( p = 0.01) and the final outcome in terms of survival ( p = 0.02). Factors significantly associated with an early PD initiation were CPB time ( p = 0.04), sepsis ( p = 0.02) and shorter PD duration ( p = 0.003). Conclusion PD is very useful mode of renal replacement therapy among pediatric postoperative cardiac surgical patients. The intraoperative and postoperative variables have important association with the time of PD initiation, PD duration and patient survival. How to cite this article Sahu MK, Bipin C, Arora Y, Singh SP, Devagouru V, Rajshekar P, et al. Peritoneal Dialysis in Pediatric Postoperative Cardiac Surgical Patients. Indian J Crit Care Med 2019;23(8):371–375.

Short-term results of sutureless closure for primary total anomalous pulmonary venous connection: seventeen cases

“…This condition at both cases was resolved before discharge. Peritoneal dialysis was used to support renal function due to acute renal failure after heart surgery which was common in neonates [22]. In our series, four obstructed TAPVC neonatal cases which required postoperative peritoneal dialysis for within first two days were withdrawn these catheters due to good urine output.…”