التفاصيل البيبلوغرافية
| العنوان: |
Cell-Free Plasma Hemoglobin and Male Gender Are Risk Factors for Acute Kidney Injury in Low Risk Children Undergoing Cardiopulmonary Bypass. |
| المؤلفون: |
Kim-Campbell, Nahmah1 nahmah.kimcampbell@chp.edu, Gretchen, Catherine1, Callaway, Clifton2, Felmet, Kathryn1, Kochanek, Patrick M.1,3, Maul, Timothy4, Wearden, Peter4,5, Sharma, Mahesh4, Viegas, Melita4, Munoz, Ricardo1, Gladwin, Mark T.6,7, Bayir, Hülya1,3 |
| المصدر: |
Critical Care Medicine. Nov2017, Vol. 45 Issue 11, pe1123-e1130. 8p. |
| مصطلحات موضوعية: |
*KIDNEY injuries, *LACTATE dehydrogenase, *CARDIOPULMONARY bypass, *ARTIFICIAL blood circulation, *ACUTE kidney failure, *BLOOD proteins, *CHILDREN'S hospitals, *CREATININE, *GLOBULINS, *HEMOGLOBINS, *LONGITUDINAL method, *RESEARCH funding, *SEX distribution, CARDIAC surgery risk factors |
| مستخلص: |
Objectives: To determine the relationship between the production of cell-free plasma hemoglobin and acute kidney injury in infants and children undergoing cardiopulmonary bypass for cardiac surgery.Design: Prospective observational study.Setting: Twelve-bed cardiac ICU in a university-affiliated children's hospital.Patients: Children were prospectively enrolled during their preoperative outpatient appointment with the following criteria: greater than 1 month to less than 18 years old, procedures requiring cardiopulmonary bypass, no preexisting renal dysfunction.Interventions: None.Measurements and Main Results: Plasma and urine were collected at baseline (in a subset), the beginning and end of cardiopulmonary bypass, and 2 hours and 24 hours after cardiopulmonary bypass in 60 subjects. Levels of plasma hemoglobin increased during cardiopulmonary bypass and were associated (p < 0.01) with cardiopulmonary bypass duration (R = 0.22), depletion of haptoglobin at end and 24 hours after cardiopulmonary bypass (R = 0.12 and 0.15, respectively), lactate dehydrogenase levels at end cardiopulmonary bypass (R = 0.27), and change in creatinine (R = 0.12). Forty-three percent of patients developed acute kidney injury. There was an association between plasma hemoglobin level and change in creatinine that varied by age (overall [R = 0.12; p < 0.01]; in age > 2 yr [R = 0.22; p < 0.01]; and in < 2 yr [R = 0.03; p = 0.42]). Change in plasma hemoglobin and male gender were found to be risk factors for acute kidney injury (odds ratio, 1.02 and 3.78, respectively; p < 0.05).Conclusions: Generation of plasma hemoglobin during cardiopulmonary bypass and male gender are associated with subsequent renal dysfunction in low-risk pediatric patients, especially in those older than 2 years. Further studies are needed to determine whether specific subgroups of pediatric patients undergoing cardiopulmonary bypass would benefit from potential treatments for hemolysis and plasma hemoglobin-associated renal dysfunction. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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