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Standardizing Discharge Furosemide Duration Following Congenital Heart Surgery.
Trivedi, Mira; Diaz-Castrillon, Carlos Eduardo; Morell, Evonne.
Afiliação
  • Trivedi M; 6619University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Diaz-Castrillon CE; Baylor College of Medicine, Houston, TX, USA.
  • Morell E; 6619University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
World J Pediatr Congenit Heart Surg ; 13(1): 16-22, 2022 01.
Article em En | MEDLINE | ID: mdl-34825593
Background: Pediatric cardiothoracic surgery has evolved over the last several decades with shorter bypass times and less need for hypothermic arrest. Diuretics have been commonly used in the post-operative period with no guidelines on duration following cardiopulmonary bypass. As a result, we conducted a single-center quality improvement project to reduce overuse of diuretics in post-operative patients without causing an increase in complications. We devised an early diuretic wean protocol that was implemented upon patient discharge. Methods: All patients who underwent uncomplicated congenital heart surgery after November 2018 were considered for the protocol. We defined an early diuretic wean protocol with a total duration of ten days of single diuretic therapy following hospital discharge. Patients were evaluated in clinic two weeks following discharge, after completion of diuretic therapy, to assess for clinical symptoms and development of effusions. Results: Retrospective pre-protocol data found the average duration a patient was on diuretics was 32 days following hospital discharge from uncomplicated congenital heart surgery. Following implementation of the protocol, there was a decrease in the total duration to 14 days, demonstrating a 56% decrease. With this practice change, there was no notable increase in adverse events. Conclusions: With implementation of the protocol, practice variability was minimized and the average post-operative diuretic duration was decreased without an increase in pleural and/or pericardial effusions or readmissiosn rates. Future directions and ongoing changes include expanding to a multicenter quality improvement collaborative focusing on decreasing the average duration of furosemide to less than five days after hospital discharge.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Furosemida / Cardiopatias Congênitas Tipo de estudo: Guideline / Observational_studies Limite: Child / Humans Idioma: En Revista: World J Pediatr Congenit Heart Surg Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Furosemida / Cardiopatias Congênitas Tipo de estudo: Guideline / Observational_studies Limite: Child / Humans Idioma: En Revista: World J Pediatr Congenit Heart Surg Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos