The effect of sildenafil on pleural and peritoneal effusions after the TCPC operation.

BACKGROUND: We evaluated whether the administration of sildenafil in children undergoing TCPC operation shortened the interval from the operation to the removal of the pleural and peritoneal drains.

METHODS: We retrospectively reviewed the data of 122 patients who had undergone the TCPC operation between 2004 and 2014. Patients were divided into two groups on the basis of their treatments. Sildenafil was orally administered preoperatively in the morning of the procedure or within 24 hours after the TCPC operation to the sildenafil group (n=48), which was compared to a control group (n=60). Fourteen patients were excluded from the study.

RESULTS: The primary outcome measure was time from the operation to the removal of the drains. The study groups had similar demographics. The median [interquartile range] time to removal of drains (sildenafil group 11 [8-19] vs. control group 11 [7-16] days, P=0.532) was comparable between the groups. The median [interquartile range] fluid balance on the first postoperative day was significantly higher (P=0.001) in the sildenafil group compared with controls (47 [12-103] vs. 7 [-6-67] ml/kg). The first postoperative day fluid balance was a significant predictor for a prolonged need for drains in the multivariate analysis.

CONCLUSIONS: Sildenafil administration, preoperatively or within 24 hours after the TCPC operation, did not reduce the required time for pleural and peritoneal drains but was associated with a significantly higher positive fluid balance. This article is protected by copyright. All rights reserved.