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The Effect of Cardiopulmonary Bypass Duration on Renal Injury after Congenital Heart Surgery in Infants and Young Children

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机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Pediat Cardiol & Cardiac Surg, Beijing 100029, Peoples R China; [2]Peking Univ, Hosp 1, Dept Pediat Nephrol, Beijing 100871, Peoples R China; [3]Capital Med Univ, Beijing Anzhen Hosp, Dept Pediat Cardiol & Cardiac Surg, 2 Anzhen Rd, Beijing 100029, Peoples R China
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关键词: renal injury cardiopulmonary bypass congenital heart surgery infants and young children

摘要:
Background. Improvements in surgical techniques and perioperative management mean that more complex cardiac procedures are being performed on very young patients. Objectives. The aim of this study is to evaluate the effects of the duration of cardiopulmonary bypass (CPB) on renal injury after congenital heart surgery in infants and young children. Material and Methods. 58 children with ages <= 3 years undergoing CPB surgery were divided into three groups according to the duration of their CPB: Group I was < 90 min, n = 15; Group II, 90-149 min, n = 25; and Group III was >= 150 min, n = 18. Urinary neutrophil gelatinase-associated lipocalin, interleukin-18, microalbumin and alpha 1-microglobulin were measured at baseline and 4 h, 6 h, 12 h and 24 h after surgery. Results. No significant differences were noted among the groups in terms of gender, age, weight and baseline serum creatinine. The incidence of acute kidney injury (based on serum creatinine increase) after surgery were 13.3% (2/15) in Group I, 52.0% (13/25) in Group II and 77.8% (14/18) in Group III. 4 children developed acute renal failure (ARF) requiring peritoneal dialysis; all of them were in Group III. The levels of urinary biomarkers increased significantly, peaked at 4 h and remained elevated up to 24 h after surgery. Group III had significantly higher levels of urinary biomarkers than Groups I and II at 4-12 h after surgery, while the levels were not significantly different at 24 h. Conclusions. Prolonged CPB duration was related to more severe renal tubular injury and acute renal failure. Measurements of urinary kidney specific biomarkers in infants and children with a CPB duration of more than 150 min might help identify those at high risk for ARF

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出版当年[2012]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验
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出版当年[2011]版:
Q4 MEDICINE, RESEARCH & EXPERIMENTAL
最新[2023]版:
Q3 MEDICINE, RESEARCH & EXPERIMENTAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2011版] 出版当年五年平均 出版前一年[2010版] 出版后一年[2012版]

第一作者:
第一作者机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Pediat Cardiol & Cardiac Surg, Beijing 100029, Peoples R China;
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Anzhen Hosp, Dept Pediat Cardiol & Cardiac Surg, Beijing 100029, Peoples R China; [3]Capital Med Univ, Beijing Anzhen Hosp, Dept Pediat Cardiol & Cardiac Surg, 2 Anzhen Rd, Beijing 100029, Peoples R China
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