Use of a Simply Modified Drainage Catheter for Peritoneal Dialysis Treatment of Acute Renal Failure Associated With Cardiac Surgery in Infants

Abstract: Acute renal failure (ARF) is a common complication in infants who undergo cardiac surgery in the intensive care unit. We report on a modified drainage catheter used in peritoneal dialysis (PD) for the treatment of ARF associated with cardiac surgery in infants. Thirty-nine infants with congenital heart disease undergoing cardiac surgery who developed ARF at our center between January 2009 and January 2012 were assessed. A modified drainage catheter for PD was used in these infants. Their demographic, clinical, and surgical data were analyzed. Thirty infants with ARF were cured by PD, and the other 9 died in the first 48 hours because of the severity of the acute cardiac dysfunction. All these infants were dependent upon mechanical ventilation during the postoperative period and used vasoactive drugs. In the survival group, the interval between the procedure and initiation of PD was 13.6 6.5 (range, 6–30) hours. PD duration was 3.9 0.9 (3–6) days. Minor complications were encountered in some patients (asymptomatic hypokalemia, hyperglycemia, and thrombo-cytopenia). These complications were readily treated by drugs or resolved spontaneously. Hemodynamics, cardiac function, and renal function improved significantly during PD. These data suggest that PD using a modified drainage catheter for ARF after cardiac surgery in infants is safe, feasible, inexpensive, and yields good results. (Medicine 93(14):e77) Abbreviations: ARF = acute renal failure, BUN = blood urea nitrogen, CPB = cardiopulmonary bypass, CVP = central venous pressure, HR = heart rate, MAP = mean arterial pressure, PD = peritoneal dialysis