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Impact of Nesiritide Infusion on Early Postoperative Recovery After Total Cavopulmonary Connection Surgery

  • Yajuan Zhang
  • Yabing Duan
  • Jun Yan
  • Qiang Wang
  • Shoujun Li
  • Haitao Xu
Original Article

Abstract

Objective

The purpose of the study is to compare the effects of nesiritide on the discharge time and pleural effusion in children with total cavopulmonary connection (TCPC), and to provide a more reasonable clinical method for these children.

Methods

Forty-four who children underwent cavopulmonary connection between January 2016 and 2017 were retrospectively collected, and 5 children were excluded from analysis due to postoperative thrombosis or second Fontan surgery due to high pulmonary hypertension. Thirteen children received nesiritide (3–11 days) plus conventional treatment as the nesiritide group, continuous infusion of nesiritide with the dose of 0.01 ug kg−1 min−1. Twenty-six children with the conventional treatment as the conventional treatment group. The length of stay in hospital and the retention time of chest drainage tube were compared between two groups.

Results

There were no significant differences in the time of cardiopulmonary bypass, postoperative ventilation time, ICU time, and vasoactive inotropic drug scores in the two groups. There were no hospital deaths in two groups. The median hospital stay was 20 days in the nesiritide group (11–56 days, means 25 days), and the median length of hospital stay was 28 days in the routine treatment group (9–95 days, means 34 days). There is no statistically significant difference between two groups with regard to the length of stay in hospital (P = 0.281). Regarding the thoracic drainage duration, the median was 17 days (9–55 days, means 22 days) in the nesiritide group and 23 days in the conventional treatment group (7–91 days, means 31 days) (P = 0.294). All the patients had no severe complications such as excessive fluid load, intractable hypotension, and liver or kidney injury.

Conclusion

Nesiritide is safe in children who underwent cavopulmonary connection surgery. Compared with the conventional treatment group, postoperative nesiritide is not associated with improved early clinical outcomes after TCPC surgery.

Keywords

Total cavopulmonary connection Nesiritide Thoracic drainage 

Notes

Acknowledgements

We gratefully acknowledge the role of all our colleagues involved in the care of these study patients.

Funding

There was no funding supporting this study.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all patients, parents, or guardians included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric Cardiac Surgery, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical SciencesPeking Union Medical CollegeBeijingPeople’s Republic of China

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