Research Article | Open Access | 10.31586/CriticalCare.0401.02

Effectiveness of Peritoneal Dialysis in Management of Acute Hyperthermia after On-Pump Heart Surgery in Infants

Abstract

Introduction: Acute hyperthermia is a common complication in the first 24 hours after open heart surgery with the incidence of 12% to 73%. The aim of this study was to evaluate the efficiency of postoperative peritoneal dialysis for controlling acute hyperthermia in pediatrics undergoing on-pump heart surgery. Methods: We reviewed clinical outcomes of 40 infants who underwent congenital surgery from August 2016 to August 2017. Patients were divided into two groups in terms of peritoneal dialysis requirement as group A and B. Demographic data, intraoperative and postoperative variables were compared between the patients. Results: Among the 40 high risk infants who underwent cardiac surgery, 20 patients were treated with peritoneal dialysis (group A). Mean rectal temperature and incidence of acute hyperthermia in 24h after surgery were higher in group A compared to group B (p ˂ 0.05). Infants in group A were younger, lighter and showed lower BSA compare to group B (p < 0.05). Also, higher concentration of serum potassium and lower urinary output were seen in group A compared to group B (p = 0.05). The incidence of neurological events was significantly higher in patients of group A (p < 0.05). Intubation time and intensive care unit stay was significantly more prolonged in the group A with peritoneal dialysis (p ˂ 0.05). Conclusion: Peritoneal dialysis performance was effective in treatment of induced hyperthermia in the first 24 h after operation. Indeed, younger age and lighter weight children are more prone to postoperative complication related to cardiopulmonary bypass surgery.

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Reference

[1]
Baskin E, et al. Acute renal failure and mortality after open-heart surgery in infants. Ren Fail. 2005; 27(5):557-560.
[2]
Carvalho MV, Maluf MA, Catani R, La Rotta CA, Gomes WJ, Salomao R, et al, Cytokines and pediatric open heart surgery with cardiopulmonary bypass. Cardiol Young. 2001;11(1):36-43.
[3]
Seghaye MC, Grabitz RG, Duchateau J, Busse S, Dabritz S, KochD, et al.Inflammatory reaction and capillary leak syndrome related to cardiopulmonary bypass inneonates undergoing cardiac operations. J Thorac Cardiovasc Surg. 1996;112(3):687-697.
[4]
Alkan T, et al. Postoperative prophylactic peritoneal dialysis in neonates and infants aftercomplex congenital cardiac surgery. ASAIO J. 2006; 52(6):693-697.
[5]
Stratman RC, Flynn JD, Hatton KW. Malignant hyperthermia: a pharmacogeneticDisorder. Orthopedics. 2009;32(11):
[6]
Metterlein T, Zink W, Kranke E, Haneya A, Graf B, Kranke P. Cardiopulmonarybypass in malignant hyperthermia susceptible patients: a systematic review of published cases. J Thorac Cardiovasc Surg. 2011;141(6):1488-1495.
[7]
Villasis-Keever MA, Zapata-Arenas DM, Penagos-Paniagua MJ.Frequency of postoperative fever in children with congenital heart disease undergoing cardiovascular surgery and associated risk factors. Rev Esp Cardiol. 2002;55(10):1063-1069.
[8]
Gupta AK, Singh VK, Varma A. Approach to postoperative fever in pediatric cardiac Patients. Ann Pediatr Cardiol. 2012;5(1):61-68.
[9]
Clark JA, Bar-Yosef S, Anderson A, Newman MF, Landolfo K, Grocott HP. Postoperative hyperthermia following off-pump versus on-pump coronary artery bypass Surgery. J Cardiothorac Vasc Anesth. 2005;19(4):426-429.
[10]
Thong WY, Strickler AG, Li S, Stewart EE, Collier CL, Vaughn WK, et al. Hyperthermia in the forty-eight hours after cardiopulmonary bypass. Anesth Analg. 2002;95(6):1489-1495.
[11]
Chan KL, et al. Peritoneal dialysis after surgery for congenital heart disease in infants and young children. Ann Thorac Surg. 2003; 76(5):1443-1449.
[12]
Bynum G, Patton J, Bowers W, Leav I, Hamlet M, Marsili M, et al. Peritoneal lavage cooling in an anesthetized dog heatstroke model. Aviat Space Environ Med. 1978;49(6):779-784.
[13]
Laffey JG, Boylan JF, Cheng DC. The systemic inflammatory response to cardiac surgery: implications for the anesthesiologist. Anesthesiology. 2002;97(1):215-252.
[14]
Boigner H, et al. Predictors of mortality at initiation of peritoneal dialysis in children after cardiac surgery. Ann Thorac Surg. 2004;77(1):61-65.

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Published
January 7, 2019
How to Cite
BIGDELIAN, Hamid; SEDIGHI, Mohsen. Effectiveness of Peritoneal Dialysis in Management of Acute Hyperthermia after On-Pump Heart Surgery in Infants. Trends Journal of Sciences Research, [S.l.], v. 4, n. 1, p. 9-13, jan. 2019. ISSN 2377-8083. Available at: <http://tjsr.org/journal/index.php/tjsr/article/view/96>. Date accessed: 21 jan. 2019.
Section
Critical Care