Author + information
Acute kidney injury (AKI) is common in infants after cardiopulmonary bypass (CPB) and is associated with poor outcomes. Peritoneal dialysis (PD) improves outcomes of adults with post CPB AKI, but pediatric data are limited. Since October 2010, we have routinely placed PD catheters (PDC) in the operating room in infants at high risk for AKI. We performed a retrospective matched cohort study to determine if infants receiving PDC would have improved outcomes.
42 infants with routine PDC placement were each age matched to an infant with similar procedure. Demographic, baseline and outcome data were compared between PDC + and PDC – infants. Our primary outcome was negative fluid balance (FB) on postoperative days 1-3. Secondary outcomes were time to negative FB, electrolyte corrective medications, and time to extubation. Data were compared with McNemar's, Wilcoxon rank sum, and paired t-tests.
Baseline data did not differ between groups. 25/42 PDC+ infants received PD; 17 were placed to passive drain. PDC+ versus PDC – infants outcomes are presented in the Table. No significant PDC related complications were seen.
PDC use is safe and associated with earlier and more reliably negative FB as well as shorter ventilation and fewer electrolyte corrections in infants at risk for post CPB AKI. Routine PDC use should be considered in high risk infants receiving CPB. Further prospective studies are vital to prove causative effects of PD.
|PDC +||PDC −||p-value|
|Age||6 days (3, 9)||5 days (3, 14)||NS|
|Weight||3.4 kg (3.0, 3.8)||3.2 kg (2.5, 3.9)||NS|
|Bypass Time||164 min (133,194)||150 min (116,186)||NS|
|Negative Fluid Balance Post-Op Day 1||57%||33%||0.04|
|Negative Fluid Balance Post-Op Day 2||85%||61%||0.01|
|Negative Fluid Balance Post-Op Day 3||67%||49%||NS|
|Time to Negative Balance||16 hours (0,24)||32 hours (24,48)||<0.0001|
|Time to Extubation||80 hours (56,128)||104 hours (48,176)||0.02|
|Total Number of Electrolyte Corrective Meds||1.5 (0,3)||3 (1,4)||0.03|
Percent or median values (25, 75th percentile)
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Cardiology Solutions: Congenital Surgical Therapies
Abstract Category: 14. Congenital Cardiology Solutions: Therapy
Presentation Number: 1119-131
- 2013 American College of Cardiology Foundation