Chen Qiang, Cao Hua, Hu Yun-Nan, Chen Liang-Wan, He Jia-Jun
Department of Cardiovascular Surgery (QC, HC, Y-nH), Union Hospital, Fujian Medical University, Fuzhou 350001, P.R. China.
Medicine (Baltimore). 2014 Sep;93(14):e77. doi: 10.1097/MD.0000000000000077.
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 thrombocytopenia). 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.
急性肾衰竭（ARF）是重症监护病房中接受心脏手术的婴儿常见的并发症。我们报告一种用于腹膜透析（PD）的改良引流导管，用于治疗婴儿心脏手术后并发的ARF。对2009年1月至2012年1月在我们中心接受心脏手术并发生ARF的39例先天性心脏病婴儿进行了评估。这些婴儿使用了改良的PD引流导管。分析了他们的人口统计学、临床和手术数据。30例ARF婴儿通过PD治愈，另外9例在最初48小时内由于急性心功能不全的严重程度而死亡。所有这些婴儿在术后均依赖机械通气并使用血管活性药物。在存活组中，手术与开始PD之间的间隔为13.6±6.5（范围6 - 30）小时。PD持续时间为3.9±0.9（3 - 6）天。一些患者出现了轻微并发症（无症状低钾血症、高血糖和血小板减少症）。这些并发症通过药物易于治疗或自行缓解。在PD期间，血流动力学、心功能和肾功能显著改善。这些数据表明，在婴儿心脏手术后使用改良引流导管进行PD治疗ARF是安全、可行、廉价的，并且效果良好。
