Prophylactic PD Catheter Placement for Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass: Systematic Review with Meta-Analysis
Bibliographic record
Abstract
Background: Infants undergoing cardiopulmonary bypass (CPB) are at high risk of fluid overload, requiring peritoneal dialysis (PD). This systematic review evaluates whether prophylactic PD catheter (PDC) insertion at the time of cardiac surgery improves post-operative outcomes. Methods: Comprehensive literature search was completed Oct-2020. We identified studies that compared children ≤18 years undergoing cardiac surgery with CPB and receiving prophylactic PDC (inserted intraoperatively or ≤24 hours postoperatively) vs. children who do not undergo prophylactic PDC placement. Data was extracted on population characteristics; perioperative variables; and short-term postoperative outcomes, including time to negative fluid balance (FB); presence and degree of fluid overload; duration of inotropic support and mechanical ventilation; hospital length of stay; and mortality. Results: Out of 1067 studies, 208 underwent full-text review for eligibility, and 15 were included: 4 randomized controlled trials; 9 cohort studies; and 2 case-control studies. Intervention was prophylactic PDC insertion with passive peritoneal drainage in 6; PD in 7; and passive peritoneal drainage or PD in 2. The comparator group typically received furosemide. Baseline characteristics were heterogeneous for the included studies with respect to age, weight, and illness severity. Surgical procedures performed were also variable within and between studies. Time to negative FB and prevention of fluid overload showed mixed results with some studies favoring prophylactic PDC and others showing no difference. Pooled unadjusted OR for in-hospital mortality was 0.75 (95% CI: 0.05-11.11) (Figure 1). No studies reported serious PDC-related complications. Risk of bias was high in most studies, due to higher illness severity in the intervention groups, small sample size, and observational nature of studies. Conclusions: Prophylactic PDC insertion is relatively safe in children undergoing cardiac surgery with CPB. Some studies have shown prophylactic PDC improves post-operative outcomes, including time to negative FB and in-hospital mortality; others have shown no difference.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.029 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.028 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".