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Article: Peritoneal Dialysis after Surgery for Congenital Heart Disease in Infants and Young Children

TitlePeritoneal Dialysis after Surgery for Congenital Heart Disease in Infants and Young Children
Authors
Issue Date2003
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur
Citation
Annals Of Thoracic Surgery, 2003, v. 76 n. 5, p. 1443-1449 How to Cite?
AbstractBackground. We determined the risk factors for peritoneal dialysis (PD) in young children undergoing open heart surgery and, in those patients requiring PD, factors associated with prolonged PD and mortality. Methods. The clinical records of 182 children, aged 3 years or younger, who had undergone open heart surgery during a 2-year period were reviewed. Demographic data, preoperative risk factors, intraoperative variables, and postoperative complications were compared between patients requiring PD and those who did not, and between survivors and nonsurvivors of PD. Results. Of the 182 patients, 31 (17%) required PD. Patients requiring PD were lighter and more likely to have required preoperative ventilation; had undergone more complex surgery requiring longer bypass and circulatory arrest; and had experienced a pulmonary hypertensive crisis (p < 0.01). Logistic regression identified circulatory arrest (relative risk, 9.4; p = 0.002), cardiopulmonary bypass duration (relative risk, 1.02; p = 0.028), and low cardiac output syndrome (relative risk, 12.9; p < 0.0001) as significant determinants. Peritoneal dialysis was effective in achieving negative fluid balance, although serum urea and creatinine levels remained static. Prolonged PD was associated with younger age, higher preoperative serum creatinine, higher postoperative oxygen requirement, postoperative pulmonary hypertensive crisis, and low cardiac output syndrome (p < 0.05). When compared with survivors (n = 22), nonsurvivors (n = 9) were more likely to have had syndrome disorders and required preoperative ventilation and higher postoperative ventilatory settings (p < 0.05). Conclusions. Risk factors for PD in young children undergoing open heart surgery are circulatory arrest, cardiopulmonary bypass duration, and low cardiac output syndrome. The preoperative and postoperative cardiopulmonary status has a significant bearing on PD duration and patient survival. © 2003 by The Society of Thoracic Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/170333
ISSN
2015 Impact Factor: 2.975
2015 SCImago Journal Rankings: 1.490
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, KLen_US
dc.contributor.authorIp, Pen_US
dc.contributor.authorChiu, CSWen_US
dc.contributor.authorCheung, YFen_US
dc.date.accessioned2012-10-30T06:07:33Z-
dc.date.available2012-10-30T06:07:33Z-
dc.date.issued2003en_US
dc.identifier.citationAnnals Of Thoracic Surgery, 2003, v. 76 n. 5, p. 1443-1449en_US
dc.identifier.issn0003-4975en_US
dc.identifier.urihttp://hdl.handle.net/10722/170333-
dc.description.abstractBackground. We determined the risk factors for peritoneal dialysis (PD) in young children undergoing open heart surgery and, in those patients requiring PD, factors associated with prolonged PD and mortality. Methods. The clinical records of 182 children, aged 3 years or younger, who had undergone open heart surgery during a 2-year period were reviewed. Demographic data, preoperative risk factors, intraoperative variables, and postoperative complications were compared between patients requiring PD and those who did not, and between survivors and nonsurvivors of PD. Results. Of the 182 patients, 31 (17%) required PD. Patients requiring PD were lighter and more likely to have required preoperative ventilation; had undergone more complex surgery requiring longer bypass and circulatory arrest; and had experienced a pulmonary hypertensive crisis (p < 0.01). Logistic regression identified circulatory arrest (relative risk, 9.4; p = 0.002), cardiopulmonary bypass duration (relative risk, 1.02; p = 0.028), and low cardiac output syndrome (relative risk, 12.9; p < 0.0001) as significant determinants. Peritoneal dialysis was effective in achieving negative fluid balance, although serum urea and creatinine levels remained static. Prolonged PD was associated with younger age, higher preoperative serum creatinine, higher postoperative oxygen requirement, postoperative pulmonary hypertensive crisis, and low cardiac output syndrome (p < 0.05). When compared with survivors (n = 22), nonsurvivors (n = 9) were more likely to have had syndrome disorders and required preoperative ventilation and higher postoperative ventilatory settings (p < 0.05). Conclusions. Risk factors for PD in young children undergoing open heart surgery are circulatory arrest, cardiopulmonary bypass duration, and low cardiac output syndrome. The preoperative and postoperative cardiopulmonary status has a significant bearing on PD duration and patient survival. © 2003 by The Society of Thoracic Surgeons.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsuren_US
dc.relation.ispartofAnnals of Thoracic Surgeryen_US
dc.subject.meshAcute Kidney Injury - Etiology - Mortality - Therapyen_US
dc.subject.meshAnalysis Of Varianceen_US
dc.subject.meshCardiac Surgical Procedures - Adverse Effects - Methodsen_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHeart Defects, Congenital - Diagnosis - Mortality - Surgeryen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMaleen_US
dc.subject.meshPeritoneal Dialysis - Adverse Effects - Methodsen_US
dc.subject.meshPostoperative Complications - Therapyen_US
dc.subject.meshProbabilityen_US
dc.subject.meshRegistriesen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshTreatment Outcomeen_US
dc.titlePeritoneal Dialysis after Surgery for Congenital Heart Disease in Infants and Young Childrenen_US
dc.typeArticleen_US
dc.identifier.emailIp, P:patricip@hku.hken_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityIp, P=rp01337en_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0003-4975(03)01026-9en_US
dc.identifier.pmid14602265-
dc.identifier.scopuseid_2-s2.0-0242552203en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0242552203&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume76en_US
dc.identifier.issue5en_US
dc.identifier.spage1443en_US
dc.identifier.epage1449en_US
dc.identifier.isiWOS:000186358600014-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridChan, KL=37004139100en_US
dc.identifier.scopusauthoridIp, P=7003622681en_US
dc.identifier.scopusauthoridChiu, CSW=8714554800en_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US

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