ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Peritoneal Dialysis After Open Heart Surgery in Children
Öztekin OTO, Cüneyt NARİN, Ünal AÇIKEL, Hakkı KAZAZ, Eyüp HAZAN, Baran UĞURLU, Nejat SARIOSMANOĞLU, Hüdai ÇATALYÜREK, Erdem SİLİSTLERİ, Kıvanç METİN
Dokuz Eylül Üniversitesi Tıp Fakültesi Göğüs Kalp ve Damar Cerrahisi Anabili Dalı, İnciraltı-İZMİR
The effect on morbidity and mortality of the use of peritoneal dialysis (PD) catheter in the postoperative period after open heart surgery for correction of complex cardiac anomalies was studied.

In the period between January 1, 1996 and April 30, 1999 silicon peritoneal dialysis catheter was inserted during the operation to 31 (14%), of the 221 pediatric cases who underwent open heart surgery. 12 of those patients were female (39%) and 19 (61%) of them were male. The mean age was 27.6 months (2-180 months) and the mean weight was 9.3 kg (3.5-33 kg). Intraoperative modified ultrafiltration at the end of the cardiopulmonary bypass was performed in all of them except 2 patients.

In 19 of them, PD was performed in the postoperative term. The indications of PD were oliguria-anuria, hyperpotassemia, deterioration of arterial oxygenation and acidosis. During postoperative period, PD catheter was also used for prevent abdominal distension. The mortality rate in the group in whom dialysis performed is 47% (9 patients). The fluid removal by PD was 53 ml/kg/24 hours. The most often complications were hyperglycemia (57.9%), the difficulty of fluid removal (42.1%) and pleural effusion (31%). Patients who were treated with PD had less inotropic support, decreasing fraction of inspired oxygen (FiO2) values easier and a clear improvement in arterial axygenation.

We conclude that PD is safe technique in infants or children who develop postoperative oliguria-anuria, hyperpotassemia, the deterioration of the arteriel oxygenation, acidosis and excessive collection of fluid in abdomen. It should be inserted prophylacticly in patients in whom these problems are anticipated. It also provides better nutrition, easy fluid management and improves pulmonary mechanics.

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