6/07/2012

Pleural effusion after Fontan Operation

Am J Cardiol 2005;96:130-3
Millwaukee. 2000-2005, n=25 (on protocol) vs. Historic controls from 1997-2000 (n=33). Median duration of pleural effusion decreased (6 days vs. 15 days).

Protocol:
80% maintenance fluids
Lasix 1 mg/kg/dose Q8 hrs, changed to Diuril + Spironolactone Q12 hrs when PO intake starts
Captopril when PO intake starts
Nasal cannula oxygen, at least 0.5 LPM
Low fat diet (30% calories from fat)

(Nitric oxide/Sildenfil)

Other papers:
Curr Opin Pulm Med 2010;16:392-6 (by E. Austin III) - summarizes several recent studies. No signficant conclusions. Highlights the uncertainty of etiology and aproach.

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