Impact of rhBNP infusion on early postoperative recovery after total cavo-pulmonary connection surgery

Abstract

Objective To compare the effects of rhBNP on the discharge time and pleural effusion in children with total cavo-pulmonary connection, and to provide a more reasonable method for the clinical treatment of postoperative children. Methods Retrospective analysis of Jan 2016 to Jan 2017 during the hospital 40 cases of complex congenital heart disease in children with total cavo-pulmonary connection clinical data, of which 5 cases due to postoperative thrombosis or postoperative venous pressure was too high and had a second Fontan surgery, the patients excluded from the inclusion criteria. 9 cases of children returned to the ward after surgery, such as cardiac, diuretic and other conventional treatment based on the application of unequal dose of rhBNP(3-11 days) for the rhBNP group, 26 cases of conventional treatment of children with conventional treatment group. By comparing the early postoperative survival rate, the number of days of hospital stay and the retention time of the thoracic drainage between the two groups. Results There were no significant differences in the time of cardiopulmonary bypass, postoperative ventilator use time, ICU time and positive inotropic drug scores in all the two groups. All the patients underwent preoperative examination with total cavo-pulmonary connection were alive and healthy discharge.The median hospital stay was 18 days in the rhBNP group(11-33 days, mean 19.2 days), and the median length of hospital stay was 28 days in the routine treatment group(9 to 95 days, mean 34.4 days). The difference of hospitalization days between the two groups was statistically significant(P=0.038). In the retention time of the thoracic drainage tube, the median thoracic drainage tube retention time was 14 days(9-27 days, mean 15.6 days) in the rhBNP group and 23 days in the conventional treatment group(7-91 days, mean 30.9(P=0.046). All the patients had no adverse effects such as excessive fluid load, intractable hypotension and liver or kidney function injury. Conclusion RhBNP can be used safely in pediatric cardiac surgery. Compared with the conventional treatment group, rhBNP has advantages in the early discharge time and the time of thoracic drainage tube removal in children with total cavo-pulmonary connection. Key words: Total cavo-pulmonary connection; RhBNP; Thoracic drainage