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Interact CardioVasc Thorac Surg 2008;7:116-120. doi:10.1510/icvts.2007.165118
© 2008 European Association of Cardio-Thoracic Surgery
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Institutional report - Congenital

Inotropic support and peritoneal dialysis adequacy in neonates after cardiac surgery

Zaccaria Riccia,*, Stefano Morellia, Claudio Roncob, Angelo Politoa, Giulia V. Stazia, Chiara Giornia, Luca Di Chiaraa and Sergio Picardoa

a Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Hospital, Piazza S.Onofrio, 00100, Rome, Italy
b Department of Nephrology Dialysis and Transplantation, St Bortolo Hospital, Vicenza, Italy

*Corresponding author. Tel.: +39 06 6859 3333.

E-mail address: zaccaria.ricci{at}fastwebnet.it (Z. Ricci).

We describe the impact of cardiovascular pharmacologic support on peritoneal dialysis adequacy in 20 neonates who required postoperative renal replacement therapy following cardiopulmonary bypass exposure. Peritoneal dialysis was administered for 2.5 (2) days. Peritoneal dialysis creatinine clearance was 3.4 (2.1) ml/min/1.73 m2 and ultrafiltration rate was 9.75 (10) ml/h. Residual creatinine clearance was 31 (26) ml/min/1.73 m2. Peritoneal dialysis creatinine clearance appeared to be a function of dialysate flow up to 100 ml/h. No correlation was present between inotropes and vasopressors infusion and peritoneal dialysis creatinine clearance/ultrafiltration rate. LDH clearance was 0.59 (0.85) ml/min/1.73 m2 and it did not appear to have a correlation with dialysate flow. Patients in-hospital mortality was 20%, significantly higher than overall neonatal population admitted to our ICU (4.8%, P=0.02). Peritoneal dialysis in neonates allows optimal ultrafiltration rate and adequate small solute clearance, irrespective of hemodynamic status or vasopressor support.

Key Words: Peritoneal dialysis; Inotropic score; Congenital heart disease; Acute kidney injury

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