Risk factors of acute kidney injury in patients after complicated cardiac surgery – the role of low cardiac output syndrome in the postoperative period
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Zakład Anestezjologii i Intensywnej Terapii, Instytut Centrum Zdrowia Matki Polki w Łodzi
Klinika Pediatrii i Immunologii z Pododdziałem Nefrologii, Instytut Centrum Zdrowia Matki Polki w Łodzi
Centrum Medycznej Diagnostyki Laboratoryjnej, Instytut Centrum Zdrowia Matki Polki w Łodzi
Marcin Tkaczyk
Klinika Pediatrii i Immunologii z Poddożylnego (ketamina), wziewnego (sewofluran), opioidu oddziałem Nefrologii, Instytut Centrum Zdrowia Matki Polki w Łodzi, ul. Rzgowska 281/289, 93-338 Łódź
Med Og Nauk Zdr. 2013;19(1):31–35
Acute kidney injury (AKI) is a frequent complication occurring after cardiac surgery. The objective of the study was the assessment of risk factors of AKI in children who had undergone high­risk complicated cardiac surgery. The study group consisted of 41 children (0­14 y.) operated due to cardiac malformation with high mean Aristotle score (9.25) as a measure of complexity of the procedure. The assessment covered as follows: complexity of procedures, clinical status of the patient, clinical and biochemical indices of cardiac function (NT­proBNP) and AKI by eGFR, and serum concentration of neutrophil gelatinase associated lipocaine concentration (NGAL). A high percentage of AKI was detected in the study group (68%); 20 patients showed stadium R whereas 8 stage I and F. The following factors of AKI (I/F) were identified: lactic academia time, higher dose of catecholamines, high postoperative drainage, and a longer time of mechanical ventilation and stay in ICU. AKI was also related to higher NGAL 24 and 48 hrs after, and higher values on NT­proBNP 24 and 48 hrs after surgery. Conclusion. The development of AKI in I/F was dependent not only on the direct injury of the procedure but also on several factors of the postoperative period with special attention paid to low cardiac output syndrome. Key words: acute kidney injury, cardiac surgery, risk factors, low cardiac output

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