Peritoneal dialysis after infant open heart surgery: Observations in 27 patients

Background. The role of peritoneal dialysis (PD) in the management of infan ts after heart operation is under discussion. The aim of this study was to investigate the effect of PD on fluid balance and outcome. Methods. Twenty-seven (33%) of 81 consecutive infants who underwent heart o peration required PD. In 22 patients (81%), PD was started prophylactically at the end of the operation. We recorded hemodynamic data and fluid balanc e. Patients experiencing acute renal failure (ARF) were compared with the r emaining infants. Results. Eleven of 81 patients (14%) experienced ARF; 3 of them died (4% of all patients undergoing operation, 27% of those with ARF). Complications o f PD, present in 33%, were transitory and of minor significance. Patients w ith ARF had decreased cardiac function compared with those without ARF but similar fluid balance. Conclusions. Peritoneal dialysis is an effective and safe method for the tr eatment of ARF in infants after open heart operation. As PD is helpful in m odulating postoperative fluid balance, prophylactic use of PD can be recomm ended for selected patients who are at risk for low cardiac output syndrome . (C) 1999 by The Society of Thoracic Surgeons.