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J Thorac Cardiovasc Surg 1997;113:64-070
© 1997 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

PERITONEAL DIALYSIS IN CHILDREN AFTER CARDIOPULMONARY BYPASS

Part of this work was presented at the meeting of the Society for Critical Care Medicine, San Francisco, Calif., Feb. 1-4, 1995.

Received for publication March 26, 1996 Revisions requested July 1, 1996 Revisions received July 22, 1996 Accepted for publication July 25, 1996 Address for reprints: Heinrich A. Werner, MD, University of Kentucky, Chandler Medical Center, MN-475B; 00843, Lexington, KY 40536.

Abstract

Objective: We reviewed 5 years' experience with peritoneal dialysis in children with acute renal failure after cardiac operations. We hypothesized that peritoneal dialysis is safe and effective in children with low-output cardiac failure after cardiac operations. Results: Mortality in these patients with renal failure (n = 32) was 46.9%. Fluid removed by peritoneal dialysis was 48 ± 28 ml/kg per 24 hours. Most complications of peritoneal dialysis were minor, hyperglycemia being the most frequent (53.1%). Peritoneal infection was suspected in 25%. Bowel perforation developed in two patients. None of the complications required early termination of dialysis. Hemodynamics and pulmonary function improved continuously during the study period. Conclusion: 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

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