Short-term renal support in postoperative repair of tetralogy of Fallot in the paediatric intensive care unit: can we predict those who need it?

Introduction Fluid balance and renal function can be difficult to manage in the postoperative infant with tetralogy of Fallot. High fluid volumes are often needed to maintain cardiac output. Aims To stratify patients at risk for advanced renal support following tetralogy of Fallot repair. Methods Retrospective analysis of all consecutive tetralogy of Fallot cases operated at a single centre in a 3-year period. Results A total of 41 children were identified. All cases had loop diuretics administered. Of the cases, 17% required support with a peritoneal dialysis catheter, with only one complication of peritoneal dialysis catheter blockage. The mean length of paediatric intensive care unit stay in those receiving peritoneal dialysis catheter insertion was prolonged by an additional mean of 6 days (p Conclusions Peritoneal dialysis is an effective method of dealing with fluid balance in children after tetralogy of Fallot repair, with minimal complications. Early consideration should be given to peritoneal dialysis when it is clear that high fluid volumes are required postoperatively.