{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:30:27Z","timestamp":1786480227408,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Inability to achieve negative fluid balance in postoperative 24 hours may be a reliable surrogate marker to start early peritoneal dialysis (PD) after cardiac surgery.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Prolonged cardiopulmonary bypass and aorta cross-clamp duration may determine PD catheter placement in the operating room.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The first postoperative 8 hours was indiscriminative for the decision to start early PD for these high-risk newborns.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The beneficial effect of peritoneal dialysis (PD) catheter placement after cardiopulmonary bypass (CPB) in young infants has been demonstrated. However, the indications to start early PD are not agreed upon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single-center study was conducted to evaluate the performance of a clinical strategy for early PD start. PD catheters were placed in the operating room after CPB. Those with prolonged CPB times (&gt;180 minutes), postoperative (postop) oligoanuria, and\/or inability to achieve negative fluid balance in postop 24 hours were evaluated as high risk and selected for early PD (PD [+]) start. All PD (+) were started within the first postop 24 hours. Primary outcomes were 5% fluid accumulation at postop 48 hours and severe AKI on postop day (POD) 5.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 49 newborns. Twenty-nine newborns were early PD (+) starts, and 20 used the PD catheter as an abdominal drain (PD \u2212). Baseline demographic data were similar. Both groups were oliguric during first postop 8 hours (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.906). The early PD (+) group produced significantly less urine output during POD 1 (0.98 versus 3.02 ml\/kg per hour;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001). At postop 48 hours, the early PD (+) group had a similar prevalence of 5% fluid accumulation as early PD (\u2212): 5 (16.7%) versus 2 (7.41%), respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.427). Severe AKI incidence on POD 5 was similar between the groups (17.3% versus 5.0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.204). Time to extubation was longer for the early PD (+) group compared with the PD (\u2212) group: 10.0 days (7.0\u201316.0) versus 4.0 days (4.0\u201310.0), respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Persistent oliguria and inability to achieve negative fluid balance during initial postop 24 hours may identify those newborns who will benefit from early PD. The first postop 8 hours was indiscriminative for this strategy. PD start may ameliorate the disadvantage for the designated group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0000000691","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T15:00:36Z","timestamp":1736348436000},"page":"531-542","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Testing of a Clinical Strategy to Start Early Peritoneal Dialysis for High-Risk Newborns after Cardiac Surgery"],"prefix":"10.34067","volume":"6","author":[{"given":"Elvia","family":"Rivera-Figueroa","sequence":"first","affiliation":[{"name":"Division of Pediatric Critical Care, Batson Children's Hospital of Mississippi, University of Mississippi, Jackson, Mississippi"},{"name":"Division of Pediatric Critical Care, Puerto Rico Women's and Children's Hospital, Ponce Health Sciences University, Bayamon, Puerto 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