Do intra-operative fluids influence the need for Post-operative cardiotropic support after a PDA ligation?

摘要:

OBJECTIVE: To investigate the effect of intra-operative intravenous fluids on post-operative hemodynamic stability. METHODS: We performed a retrospective cohort study of 98 preterm infants who underwent a patent ductus arteriosus (PDA) ligation in one NICU between 2001 and 2007. The primary outcome was the need for cardiotropic support within 24 hrs of ligation. RESULTS: Twenty-seven infants (28%) required post-operative cardiotropic support. The amount of intra-operative fluids varied between 0 and 50.4 mL/kg (median: 10.2 mL/kg). No intra-operative fluid was recorded in 26 patients. Fluids were not associated with the need for post-operative cardiotropic support (P=0.10). Using a multivariate logistic regression model, age at ligation, weight at ligation and pre-operative FiO2 were significant predictors of post-operative cardiotropic support. CONCLUSIONS: Intra-operative fluids do not appear to be associated with the need for post-operative cardiotropic support. A prospective cohort study may help identify modifiable risk factors and improve outcomes in this population.

Abstract:

OBJECTIVE: To investigate the effect of intra-operative intravenous fluids on post-operative hemodynamic stability. METHODS: We performed a retrospective cohort study of 98 preterm infants who underwent a patent ductus arteriosus (PDA) ligation in one NICU between 2001 and 2007. The primary outcome was the need for cardiotropic support within 24 hrs of ligation. RESULTS: Twenty-seven infants (28%) required post-operative cardiotropic support. The amount of intra-operative fluids varied between 0 and 50.4 mL/kg (median: 10.2 mL/kg). No intra-operative fluid was recorded in 26 patients. Fluids were not associated with the need for post-operative cardiotropic support (P=0.10). Using a multivariate logistic regression model, age at ligation, weight at ligation and pre-operative FiO2 were significant predictors of post-operative cardiotropic support. CONCLUSIONS: Intra-operative fluids do not appear to be associated with the need for post-operative cardiotropic support. A prospective cohort study may help identify modifiable risk factors and improve outcomes in this population.