title: Percutaneous intraperitoneal catheters in neonates following open heart surgery.
abstract: OBJECTIVE
  Ascitic fluid in the peritoneal cavity may severely impair respiratory and renal function following neonatal heart surgery. It has been our practice to liberally insert percutaneous peritoneal catheters (PPCs) in order to manage fluid balance and thereby improve ventilatory function. We herein report our experience with PPC.
  
  
  METHODS
  Retrospective analysis of charts of all surviving neonates that underwent PPC insertion from January 2007 through March 2010. Charts were reviewed for demographic and clinical variables from the preoperative, operative, and postoperative periods.
  
  
  RESULTS
  A total of 1268 patients underwent surgery, 292 (23%) were neonates. 17 (5.8%) patients required PPC. Mean age and weight were 16 days and 3.1 kg, respectively. Mean amount drained upon insertion was 55 ± 46 ml. Catheters were maintained for a mean of 5 days and drained an average of 201 ml on the first postinsertion day. Ventilatory settings did not change significantly prior to and postcatheter insertion (respiratory rate [29 ± 3.8 vs 28.7 ± 3.9; P = .93], inspiratory pressures [26.3 ± 3.6 vs 26.1 ± 3.3 cm H2O; P = .34], and fraction of inspired oxygen [0.66 ± 0.21 vs 0.63 ± 0.18; P = .53]). Carbon dioxide values decreased significantly (43.2 ± 9.7 vs 37 ± 4.9 mm Hg; P = .01), and PO2 values increased (78 ± 69 vs 104 ± 57 mm Hg; P = .05).
  
  
  CONCLUSIONS
  The PPC insertion can be easily performed at the bedside with minimal complications. Fluid balance management is facilitated, and ventilation is improved. The PPC insertion is a valuable addition to the armamentarium of the physician treating neonates in the intensive care unit after complex congenital heart surgery.
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
authors.forename: Noa
authors.initials: N
authors.lastname: Averbuch
authors.forename: Einat
authors.initials: E
authors.lastname: Birk
authors.forename: Georgy
authors.initials: G
authors.lastname: Frenkel
authors.forename: Omar
authors.initials: O
authors.lastname: Gogia
authors.forename: Orit Manor
authors.initials: OM
authors.lastname: Shulman
authors.forename: Elchanan
authors.initials: E
authors.lastname: Bruckheimer
authors.forename: Elchanan
authors.initials: E
authors.lastname: Nachum
authors.forename: Gabriel
authors.initials: G
authors.lastname: Amir
mesh_terms: D001202:Ascitic Fluid; D001784:Blood Gas Analysis; D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling; D004322:Drainage / Q000379:methods; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D012189:Retrospective Studies
keywords: congenital heart surgery; fluid balance; intensive care; peritoneal catheters; ventilation