دورية أكاديمية

Intraoperative hemodynamic factors predicting early postoperative renal function in pediatric kidney transplantation

التفاصيل البيبلوغرافية
العنوان: Intraoperative hemodynamic factors predicting early postoperative renal function in pediatric kidney transplantation
المؤلفون: Michelet, Daphné, Brasher, Christopher, Marsac, Lucile, Zanoun, Nabil, Assefi, Mona, Elghoneimi, Alaa, Dauger, Stephane, Dahmani, Souhayl
المساهمون: Ramamoorthy, Chandra
المصدر: Pediatric Anesthesia ; volume 27, issue 9, page 927-934 ; ISSN 1155-5645 1460-9592
بيانات النشر: Wiley
سنة النشر: 2017
المجموعة: Wiley Online Library (Open Access Articles via Crossref)
الوصف: Summary Background The anesthetic management of kidney transplantation in children remains somewhat empirical. The goal of the present study was to investigate intraoperative hemodynamic factors affecting posttransplantation kidney function. Methods We performed a retrospective analysis of data from patients undergoing kidney transplantation in our pediatric teaching hospital from 2000 to 2014. Data collected included: donor and recipient demographic data, recipient comorbidities, fluids administered intraoperatively, and intraoperative blood pressure and central venous pressure. The main outcome of the study was the creatinine clearance at day 1 corrected to a body surface area of 1.73 m². Analysis was performed using Classification Tree Analysis with 10‐fold cross‐validation. Results One hundred and two patients were included. The following predictors of increased postoperative creatinine clearance at day 1 were identified: decreasing recipient weight, mean blood pressure‐to‐weight ratio 10 minutes after reperfusion, reduced cold ischemia duration, and increased intraoperative albumin infusion. Increased creatinine clearance was observed when mean blood pressure‐to‐weight ratio 10 minutes after reperfusion was ≥4.3 in patients weighing 13‐21 kg and ≥2.5 in those ≥22 kg. Overall, the model explained 64% (and at cross‐validation 60%) of creatinine clearance variability at day 1. Conclusion Intraoperative hemodynamics during kidney transplantation should be optimized in order to increase mean blood pressure according to values indicated by our analyses. Cold ischemia duration should be shortened as far as possible.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1111/pan.13201
الإتاحة: https://doi.org/10.1111/pan.13201Test
حقوق: http://onlinelibrary.wiley.com/termsAndConditions#vorTest
رقم الانضمام: edsbas.61F3AF2E
قاعدة البيانات: BASE