TY - JOUR
T1 - Peritoneal catheters in neonates undergoing complex cardiac surgery
T2 - A multi-centre descriptive study
AU - Kwiatkowski, David M.
AU - Alten, Jeffrey A.
AU - Raymond, Tia T.
AU - Selewski, David T.
AU - Blinder, Joshua J.
AU - Afonso, Natasha S.
AU - Coghill, Matthew T.
AU - Cooper, David S.
AU - Koch, Joshua D.
AU - Krawczeski, Catherine D.
AU - Mah, Kenneth E.
AU - Neumayr, Tara M.
AU - Rahman, A. K.M.Fazlur
AU - Reichle, Garret
AU - Tabbutt, Sarah
AU - Webb, Tennille N.
AU - Borasino, Santiago
N1 - Publisher Copyright:
© The Author(s), 2023. Published by Cambridge University Press.
PY - 2024/2/20
Y1 - 2024/2/20
N2 - Background: The use of peritoneal catheters for prophylactic dialysis or drainage to prevent fluid overload after neonatal cardiac surgery is common in some centres; however, the multi-centre variability and details of peritoneal catheter use are not well described. Methods: Twenty-two-centre NEonatal and Pediatric Heart Renal Outcomes Network (NEPHRON) study to describe multi-centre peritoneal catheter use after STAT category 3-5 neonatal cardiac surgery using cardiopulmonary bypass. Patient characteristics and acute kidney injury/fluid outcomes for six post-operative days are described among three cohorts: peritoneal catheter with dialysis, peritoneal catheter with passive drainage, and no peritoneal catheter. Results: Of 1490 neonates, 471 (32%) had an intraoperative peritoneal catheter placed; 177 (12%) received prophylactic dialysis and 294 (20%) received passive drainage. Sixteen (73%) centres used peritoneal catheter at some frequency, including six centres in >50% of neonates. Four centres utilised prophylactic peritoneal dialysis. Time to post-operative dialysis initiation was 3 hours [1, 5] with the duration of 56 hours [37, 90]; passive drainage cohort drained for 92 hours [64, 163]. Peritoneal catheter were more common among patients receiving pre-operative mechanical ventilation, single ventricle physiology, and higher complexity surgery. There was no association with adverse events. Serum creatinine and daily fluid balance were not clinically different on any post-operative day. Mortality was similar. Conclusions: In neonates undergoing complex cardiac surgery, peritoneal catheter use is not rare, with substantial variability among centres. Peritoneal catheters are used more commonly with higher surgical complexity. Adverse event rates, including mortality, are not different with peritoneal catheter use. Fluid overload and creatinine-based acute kidney injury rates are not different in peritoneal catheter cohorts.
AB - Background: The use of peritoneal catheters for prophylactic dialysis or drainage to prevent fluid overload after neonatal cardiac surgery is common in some centres; however, the multi-centre variability and details of peritoneal catheter use are not well described. Methods: Twenty-two-centre NEonatal and Pediatric Heart Renal Outcomes Network (NEPHRON) study to describe multi-centre peritoneal catheter use after STAT category 3-5 neonatal cardiac surgery using cardiopulmonary bypass. Patient characteristics and acute kidney injury/fluid outcomes for six post-operative days are described among three cohorts: peritoneal catheter with dialysis, peritoneal catheter with passive drainage, and no peritoneal catheter. Results: Of 1490 neonates, 471 (32%) had an intraoperative peritoneal catheter placed; 177 (12%) received prophylactic dialysis and 294 (20%) received passive drainage. Sixteen (73%) centres used peritoneal catheter at some frequency, including six centres in >50% of neonates. Four centres utilised prophylactic peritoneal dialysis. Time to post-operative dialysis initiation was 3 hours [1, 5] with the duration of 56 hours [37, 90]; passive drainage cohort drained for 92 hours [64, 163]. Peritoneal catheter were more common among patients receiving pre-operative mechanical ventilation, single ventricle physiology, and higher complexity surgery. There was no association with adverse events. Serum creatinine and daily fluid balance were not clinically different on any post-operative day. Mortality was similar. Conclusions: In neonates undergoing complex cardiac surgery, peritoneal catheter use is not rare, with substantial variability among centres. Peritoneal catheters are used more commonly with higher surgical complexity. Adverse event rates, including mortality, are not different with peritoneal catheter use. Fluid overload and creatinine-based acute kidney injury rates are not different in peritoneal catheter cohorts.
KW - Acute kidney injury
KW - Fluid overload
KW - Neonatal cardiac surgery
KW - Peritoneal catheter
KW - Peritoneal dialysis
UR - http://www.scopus.com/inward/record.url?scp=85163680231&partnerID=8YFLogxK
U2 - 10.1017/S104795112300135X
DO - 10.1017/S104795112300135X
M3 - Article
C2 - 37337694
AN - SCOPUS:85163680231
SN - 1047-9511
VL - 34
SP - 272
EP - 281
JO - Cardiology in the young
JF - Cardiology in the young
IS - 2
ER -