Creatinine correction to account for fluid overload in children with acute respiratory distress syndrome treated with extracorporeal membrane oxygenation: an initial exploratory report.

Autor: Redant, Sébastien, De Bels, David, Barbance, Océane, Massaut, Jacques, Honoré, Patrick M., Taccone, Fabio S., Biarent, Dominique
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Zdroj: Pediatric Nephrology; Apr2022, Vol. 37 Issue 4, p891-898, 8p, 1 Diagram, 7 Charts, 3 Graphs
Abstrakt: Background: Creatinine is distributed between the intracellular and extracellular compartments, and as a result, the measurement of its concentration is strongly related to the fluid status of the patient. An interest has been shown in correcting measured serum creatinine levels according to the fluid balance in order to better specify the degree of acute kidney injury (AKI). Methods: We conducted a retrospective observational study of 33 children, aged 0 to 5 years, admitted to the pediatric intensive care unit for acute respiratory distress syndrome treated by extracorporeal membrane oxygenation. We compared measured and corrected creatinine and assessed the degree of agreement between these values using both Cohen's kappa and Krippendorff's alpha coefficient. Results: In our cohort, 37% of the classifications made according to measured creatinine levels were erroneous and, in the majority of cases, the degree of AKI was underestimated. Conclusion: Correction of the measured creatinine value according to the degree of fluid overload may result in more accurate diagnosis of AKI. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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