Hindawi Publishing Corporation Case Reports in Medicine Volume 2010, Article ID 731865, 3 pages doi:10.1155/2010/731865 Case Report Draining Fluids through a Peritoneal Catheter in Newborns after Cardiac Surgery Helps to Control Fluid Balance Elisa Ruano Cea,1 Philippe Jouvet,2 Suzanne Vobecky,3 and Aicha Merouani1 1 Department of Pediatric Nephrology, CHU Sainte-Justine Hospital, University of Montr´eal, 3175, Coˆte Sainte Catherine, Montr´eal, QC, Canada H3T 1C5 2 Pediatric Intensive Care, Sainte-Justine Hospital, University of Montr´eal, QC, Canada H3T 1C5 3 Cardiac Surgery, Sainte-Justine Hospital, University of Montr´eal, QC, Canada H3T 1C5 Correspondence should be addressed to Aicha Merouani, aicha.merouani.hsj@ssss.gouv.qc.ca Received 23 November 2009; Revised 12 March 2010; Accepted 19 March 2010 Academic Editor: Bruno Megarbane Copyright © 2010 Elisa Ruano Cea et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Fluid overload, a common complication following cardiac surgery in infants is often diﬃcult to manage. Dialysis can be used in severe cases, but may not be well tolerated. In such patients, peritoneal drainage could be an alternative option for ﬂuid removal. We report the case of a newborn with a truncus arteriosus who developed postoperatively a complicated clinical course with right ventricular dysfunction, prerenal condition as well as ﬂuid overload despite diuretic therapy. Dialysis was indicated for ﬂuid removal. Peritoneal dialysis was started using a surgically placed Tenckhoﬀ catheter and stopped due to ineﬃcacy and leaks and no other modalities of dialysis were used. However, the catheter was left in place over a period of two months for ﬂuid drainage and removed because of unexplained fever. In order to determine the eﬀect of peritoneal drainage, we selected a period of one week before and one week after the removal of the drain to compare daily clinical data, urine electrolytes and renal function and found a positive eﬀect on ﬂuid balance control. We conclude that the ﬂuid removal by continuous peritoneal drainage is a simple and safe alternative that can be used to control ﬂuid balance in infants after cardiac surgery. 1. Introduction Fluid overload is a common complication following cardiac surgery in infants. The cause is thought to be multifactorial and includes pre-existing cardiac dysfunction, exogenous ﬂuid during cardiopulmonary bypass, postsurgery acute kidney injury and the strain on the heart caused by the surgical procedure [1–3]. Conservative management such as the use of diuretics is often insuﬃcient to adequately manage ﬂuid overload. Ultraﬁltration through peritoneal dialysis or hemodialysis can be used in severe cases [4, 5], but may not be well tolerated. The insertion of a peritoneal drain and its use to remove peritoneal ﬂuid postoperatively is commonly used in pediatric cardiac surgery especially when newborns with complex diseases are involved but data have never been published. In this case report, we describe a newborn patient in whom a peritoneal drain helped the management of his ﬂuid balance after cardiac surgery. 2. Case Report The patient described here was born to a mother known with insulin dependant type 2 diabetes. The pregnancy was overall uncomplicated, but antenatal ultrasounds revealed the presence of a truncus arteriosus. Delivery was induced at 40 weeks gestational age and was complicated by shoulder dystocia as well as thick meconium ﬂuid, but no invasive resuscitation was required. Birth weight was 4.0 kg and Apgars were 7, 9, 9 at 1, 5 and 10 minutes, respectively. Cardiac ultrasound conﬁrmed the presence of only congenital abnormalities with a truncus arteriosus type