T K Susheel Kumar1, Jerry Allen Ccp2, Thomas Spentzas Md3, Lindsay Berrios Ccp2, Samir Shah Md4, Vijaya M Joshi Md4, Jean A Ballweg Md4, Christopher J Knott-Craig Md1. 1. Department of Pediatric Cardiothoracic Surgery, LeBonheur Children's Hospital and University of Tennessee, Memphis, TN, USA tskumar@uthsc.edu. 2. Department of Pediatric Cardiothoracic Surgery, LeBonheur Children's Hospital and University of Tennessee, Memphis, TN, USA. 3. Departments of Pediatrics and Epidemiology, LeBonheur Children's Hospital and University of Tennessee, Memphis, TN, USA. 4. Department of Pediatric Cardiology. LeBonheur Children's Hospital and University of Tennessee, Memphis, TN, USA.
Abstract
OBJECTIVE: Acute kidney injury (AKI) following cardiac surgery is a serious complication with a reported incidence of 30% to 50%. This study sought to determine the prevalence and risk factors for AKI among neonates and young infants undergoing repair of cardiac defects at an institution using novel perioperative strategies. METHODS: A retrospective analysis of 102 consecutive infants (<2 months) undergoing repair of cardiac defects on cardiopulmonary bypass formed the study group. Cardiac diagnoses were stratified according to the Society of Thoracic Surgeons Congenital Heart Surgery (STAT) mortality categories. The prevalence of AKI within 72 hours was defined according to the three-stage Acute Kidney Injury Network criteria. Novel bypass strategies to preserve renal function included maintenance of higher hematocrit and high flow rates on cardiopulmonary bypass despite systemic hypothermia, and avoidance of albumin and milrinone in the perioperative period. RESULTS: Mean age was 24 ± 19 days. Eighteen patients were less than 7 days of age at the time of surgery. Patient distribution according to STAT categories was as follows: 1 (n = 21), 2 (n = 12), 3 (n = 22), 4 (n = 28), and 5 (n = 19). The incidence of stages 1, 2, and 3 AKI in the population was 8% (n = 9), 2% (n = 2), and 0% (n = 0), respectively. On multivariate analysis higher STAT category was the only significant risk factor for AKI. CONCLUSION: Current incidence of AKI following cardiac surgery in young infants at our institution is low. Novel perioperative strategies may have contributed to the low observed incidence of AKI in our patient population. Increased complexity of heart disease was a risk factor for AKI.
OBJECTIVE:Acute kidney injury (AKI) following cardiac surgery is a serious complication with a reported incidence of 30% to 50%. This study sought to determine the prevalence and risk factors for AKI among neonates and young infants undergoing repair of cardiac defects at an institution using novel perioperative strategies. METHODS: A retrospective analysis of 102 consecutive infants (<2 months) undergoing repair of cardiac defects on cardiopulmonary bypass formed the study group. Cardiac diagnoses were stratified according to the Society of Thoracic Surgeons Congenital Heart Surgery (STAT) mortality categories. The prevalence of AKI within 72 hours was defined according to the three-stage Acute Kidney Injury Network criteria. Novel bypass strategies to preserve renal function included maintenance of higher hematocrit and high flow rates on cardiopulmonary bypass despite systemic hypothermia, and avoidance of albumin and milrinone in the perioperative period. RESULTS: Mean age was 24 ± 19 days. Eighteen patients were less than 7 days of age at the time of surgery. Patient distribution according to STAT categories was as follows: 1 (n = 21), 2 (n = 12), 3 (n = 22), 4 (n = 28), and 5 (n = 19). The incidence of stages 1, 2, and 3 AKI in the population was 8% (n = 9), 2% (n = 2), and 0% (n = 0), respectively. On multivariate analysis higher STAT category was the only significant risk factor for AKI. CONCLUSION: Current incidence of AKI following cardiac surgery in young infants at our institution is low. Novel perioperative strategies may have contributed to the low observed incidence of AKI in our patient population. Increased complexity of heart disease was a risk factor for AKI.
Authors: Farrukh Javed; Nabil Abdulrahman Aleysae; Abdulmajid Yahya Al-Mahbosh; Amal Ali Zubani; Ali Mohammed Atash; Hanan Bin Salem; Mohamed Abdallah; Omaima Alkhatib; Ashraf Abu-Adas; Maymoona Abdelmouz Hrays; Nawal Ali Alqarni; Alla Felemban; Saad Abdullah Alsaedi; Ahmed Abdullah Jamjoom Journal: J Saudi Heart Assoc Date: 2021-10-15
Authors: Özgün Uygur; Özge Altun Köroğlu; Reşit Ertürk Levent; Eser Sözmen; Firat Ergin; Yüksel Atay; Mehmet Yalaz; Mete Akisü; Nilgün Kültürsay Journal: Turk J Med Sci Date: 2021-02-26 Impact factor: 0.973