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Archivos argentinos de pediatría

Print version ISSN 0325-0075On-line version ISSN 1668-3501

Abstract

GRAZIANI, M. Paula et al. Acute kidney injury in children after cardiac surgery: Risk factors and outcomes. A retrospective cohort study. Arch. argent. pediatr. [online]. 2019, vol.117, n.6, pp.e557-e567.  Epub Dec 01, 2019. ISSN 0325-0075.  http://dx.doi.org/10.5546/aap.2019.e557.

Introduction

Acute kidney injury (AKI) has been described as a common complication ofcardiac surgery in pediatric patients, whoseimpact on morbidity and mortality has beendocumented. Its incidence has been estimated tobe approximately 40 % in this patient group. Theobjective of this study was to estimate the incidenceof AKI in patients who underwent cardiovascularsurgery and to define associated risk factors andthe impact of AKI on the parameters of the postoperative course.

Population and methods

This was a retrospective, observational study of pediatricpatients who underwent cardiovascularsurgery between January 2015 and December2017 at Hospital Británico de Buenos Aires. The incidence of AKI was defined as per the Kidney Disease: Improving Global Outcomescriteria, based on pre- and post-operative bloodcreatinine levels and urine output.

Results

A total of 125 patients were included. Of them, 35 % developed AKI. The analysis of riskfactors showed a statistically significant differencefor the administration of vancomycin and thiazidediuretics, red blood cell transfusion requirement, extracorporeal circulation pump time, clamp time, maximal intraoperative lactate level, minimumtemperature, and delayed chest closure. In relationto the parameters of the post-operative course, weobserved a longer hospital stay, higher inotropicrequirement, more days of mechanical ventilation, bleeding, and neurological complications.

Conclusion

In this study, the incidence of AKI was 35 %. Modifiable and non-modifiableassociated risk factors were defined and a greaterrate of complications was observed in patientswho developed AKI.

Keywords : Acute kidney injury; Cardiovascular surgery; Pediatrics.

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