title: Passive peritoneal drainage improves fluid balance after surgery for congenital heart disease.
abstract: OBJECTIVE
  In some centers, passive peritoneal drainage (PD) is implemented following surgery for congenital heart disease. The utility of this practice has yet to be studied. We hypothesized that passive PD can promote negative fluid balance without compromising intravascular volume.
  
  
  METHODS
  A retrospective review of infants who underwent repair of complete atrioventricular septal defect (AVSD) between 6/2006 and 8/2010 was completed. Data are represented as mean ± standard deviation.
  
  
  RESULTS
  Thirty-six infants underwent AVSD repair, 18 of whom had PD catheters placed without complication. Infants with passive PD had longer duration of cardiopulmonary bypass (211 ± 59 vs 137 ± 41 min, P < 0.001) and aortic cross-clamp (148 ± 29 vs 102 ± 21 min, P < 0.001); had higher Aristotle complexity score (12.6 ± 3 vs 10.7 ± 2, P = 0.03) and ventilatory support immediately after surgery (ventilation index score 19.5 ± 6.5 vs 14.3 ± 2.5, P = 0.004); and received greater fluid administration (225 ± 6 3 vs 168 ± 45 ml kg(-1), P = 0.002) in the first 48 postoperative hours. Despite these differences, infants with passive PD achieved negative fluid balance more rapidly (12 ± 10 vs 27.3 ± 13 h, P < 0.0001) and to a greater extent (-73 + 55 vs +2.6 + 39 mL kg(-1) at 48 h, P = 0.002). Moreover, postoperative hemodynamics, urine output, creatinine clearance, blood urea nitrogen, peak lactate, and duration of mechanical ventilation were similar between groups.
  
  
  CONCLUSIONS
  Passive PD is safe and promotes negative fluid balance after repair of complete AVSD without adversely affecting intravascular volume.
authors.affiliation: Department of Pediatrics, Children's Hospital of Michigan, In affiliation with Wayne State University, MI 48201, USA.
authors.forename: Arun
authors.initials: A
authors.lastname: Saini
authors.forename: Ralph E
authors.initials: RE
authors.lastname: Delius
authors.forename: Shivaprakash
authors.initials: S
authors.lastname: Seshadri
authors.forename: Henry
authors.initials: H
authors.lastname: Walters
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Mastropietro
mesh_terms: D000886:Anthropometry / Q000379:methods; D004322:Drainage / Q000379:methods; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010529:Peritoneal Cavity; D011182:Postoperative Care / Q000379:methods*; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000502:physiology*