Babies born with hypoplastic left heart syndrome (HLHS) have three separate, complex heart surgeries before they turn three years of age. The first surgery typically happens in the first two weeks of life. After this operation, babies come back to the intensive care unit with their chests open. Babies who have heart surgery retain body water after surgery and this extra water slows recovery. Surgeons cannot close the chest until the baby gets rid of the extra water. As a result, babies have to stay in the intensive care unit and on a breathing machine for longer. Peritoneal dialysis, also known as PD, involves placing a small catheter into the belly cavity at the time of surgery. PD helps the kidney to get rid of extra body water. PD involves putting small amounts of special fluid into the belly through the catheter. This special fluid attracts water and is drained hourly. By allowing the belly cavity to drain, this helps both the heart and the lungs. This allows the chest to be closed and the breathing tube to be removed. The investigators are looking to see how quickly the babies, with and without PD, get rid of the extra water in turn shortening their stay in the intensive care unit and in the hospital. PD is not permanent, and only used for the first few days after the operation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
22
Prophylactic peritoneal dialysis
Stollery Children's Hospital
Edmonton, Alberta, Canada
Time to First Post-operative Negative 24 Hour Fluid Balance
Time to first post-operative negative fluid balance which occurred in first 72 hrs
Time frame: up to 72 hours
Time to Sternal Closure
Time frame: Up to 200 hours
Time to Lactate Less Than or Equal to 2mmol/L
Time to lactate less than or equal to 2mmol/L typically occurred in first 24 hrs
Time frame: From time of admission in PICU until assessment was reached, assessed up to 24 hours
Time to First Extubation
Time frame: Up to 15 days
Maximum Vasoactive Inotrope Score (VIS) on Post-operative Days 2-5
The maximum VIS assessed from days 2-5 will be chosen. A total VIS score is reported; there are no subscales. Minimum VIS is 0 (there are no units to VIS). Maximum VIS could be 100 but numbers are more typically 5-40. Higher VIS represent more inotropic support and potentially worse outcomes.
Time frame: Assessed at days 2, 3, 4 and 5 with the highest score from those 4 days reported
Hospital Length of Stay
Time frame: Assessed up to 8 weeks
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