OBJECTIVES: Acute kidney injury is a frequent complication following neonatal cardiac surgery and is associated with significant morbidity and mortality. The objectives of this study were to determine if plasma neutrophil gelatinase-associated lipocalin levels were associated with acute kidney injury and clinical outcomes in neonates with congenital heart disease undergoing cardiopulmonary bypass. DESIGN: Retrospective single-center observational study. SETTING: A pediatric cardiac ICU within a tertiary-care academic hospital. PATIENTS: Patients age less than 30 days undergoing cardiac surgery requiring cardiopulmonary bypass. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Plasma neutrophil gelatinase-associated lipocalin peaked at 12 hours postcardiopulmonary bypass and more than doubled compared with preoperative levels. Higher preoperative and 24-hour postoperative neutrophil gelatinase-associated lipocalin levels were associated with acute kidney injury (r = 0.30, r = 0.49), longer duration of mechanical ventilation (r = 0.40, r = 0.51), ICU (r = 0.32, r = 0.33) and hospital lengths of stay (r = 0.28, r = 0.32), and total hospital charges (r = 0.35, r = 0.30; all p values < 0.05). CONCLUSIONS: Both preoperative and 24-hour postoperative plasma neutrophil gelatinase-associated lipocalin levels are associated with acute kidney injury and worse clinical outcomes in neonates undergoing cardiac surgery. Plasma neutrophil gelatinase-associated lipocalin levels may have a role in risk stratification for predicting postoperative renal dysfunction as well as providing a potential clinical trajectory in the postoperative period.
OBJECTIVES:Acute kidney injury is a frequent complication following neonatal cardiac surgery and is associated with significant morbidity and mortality. The objectives of this study were to determine if plasma neutrophil gelatinase-associated lipocalin levels were associated with acute kidney injury and clinical outcomes in neonates with congenital heart disease undergoing cardiopulmonary bypass. DESIGN: Retrospective single-center observational study. SETTING: A pediatric cardiac ICU within a tertiary-care academic hospital. PATIENTS: Patients age less than 30 days undergoing cardiac surgery requiring cardiopulmonary bypass. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Plasma neutrophil gelatinase-associated lipocalin peaked at 12 hours postcardiopulmonary bypass and more than doubled compared with preoperative levels. Higher preoperative and 24-hour postoperative neutrophil gelatinase-associated lipocalin levels were associated with acute kidney injury (r = 0.30, r = 0.49), longer duration of mechanical ventilation (r = 0.40, r = 0.51), ICU (r = 0.32, r = 0.33) and hospital lengths of stay (r = 0.28, r = 0.32), and total hospital charges (r = 0.35, r = 0.30; all p values < 0.05). CONCLUSIONS: Both preoperative and 24-hour postoperative plasma neutrophil gelatinase-associated lipocalin levels are associated with acute kidney injury and worse clinical outcomes in neonates undergoing cardiac surgery. Plasma neutrophil gelatinase-associated lipocalin levels may have a role in risk stratification for predicting postoperative renal dysfunction as well as providing a potential clinical trajectory in the postoperative period.
Authors: Gebhard Wagener; Michael Jan; Mihwa Kim; Kiyoshi Mori; Jonathan M Barasch; Robert N Sladen; H Thomas Lee Journal: Anesthesiology Date: 2006-09 Impact factor: 7.892
Authors: Eric M Graham; Andrew M Atz; Ryan J Butts; Nathaniel L Baker; Sinai C Zyblewski; Rachael L Deardorff; Stacia M DeSantis; Scott T Reeves; Scott M Bradley; Francis G Spinale Journal: J Thorac Cardiovasc Surg Date: 2011-05-20 Impact factor: 5.209
Authors: Andrés José Alcaraz; Maite Augusta Gil-Ruiz; Ana Castillo; Jorge López; Carlos Romero; Sarah Nicole Fernández; Angel Carrillo Journal: Pediatr Crit Care Med Date: 2014-02 Impact factor: 3.624
Authors: Andrea Lassnigg; Daniel Schmidlin; Mohamed Mouhieddine; Lucas M Bachmann; Wilfred Druml; Peter Bauer; Michael Hiesmayr Journal: J Am Soc Nephrol Date: 2004-06 Impact factor: 10.121
Authors: Eero J Pesonen; Pertti K Suominen; Juho Keski-Nisula; Ilkka P Mattila; Paula Rautiainen; Timo Jahnukainen Journal: Pediatr Crit Care Med Date: 2016-02 Impact factor: 3.624
Authors: Jennifer G Jetton; Louis J Boohaker; Sidharth K Sethi; Sanjay Wazir; Smriti Rohatgi; Danielle E Soranno; Aftab S Chishti; Robert Woroniecki; Cherry Mammen; Jonathan R Swanson; Shanty Sridhar; Craig S Wong; Juan C Kupferman; Russell L Griffin; David J Askenazi Journal: Lancet Child Adolesc Health Date: 2017-11
Authors: Catherine L Dent; Qing Ma; Sudha Dastrala; Michael Bennett; Mark M Mitsnefes; Jonathan Barasch; Prasad Devarajan Journal: Crit Care Date: 2007 Impact factor: 9.097