Wider intraoperative glycemic fluctuation increases risk of acute kidney injury after pediatric cardiac surgery

Autor: Lian Duan, Yan-Ying Duan, Guo-Huang Hu, Meng Jiang, Cheng-Liang Zhang
Rok vydání: 2018
Předmět:
Blood Glucose
Male
medicine.medical_specialty
030204 cardiovascular system & hematology
lcsh:RC870-923
urologic and male genital diseases
Critical Care and Intensive Care Medicine
Risk Assessment
Severity of Illness Index
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Monitoring
Intraoperative
Internal medicine
glycemic fluctuation
medicine
Humans
030212 general & internal medicine
Cardiac Surgical Procedures
Child
Propensity Score
Retrospective Studies
Glycemic
urogenital system
business.industry
Incidence
Acute kidney injury
Infant
General Medicine
Acute Kidney Injury
lcsh:Diseases of the genitourinary system. Urology
medicine.disease
female genital diseases and pregnancy complications
Cardiac surgery
Logistic Models
pediatric
Nephrology
Child
Preschool
embryonic structures
Clinical Study
Cardiology
Female
intraoperative
business
cardiac surgery
Zdroj: Renal Failure
Renal Failure, Vol 40, Iss 1, Pp 611-617 (2018)
ISSN: 1525-6049
0886-022X
DOI: 10.1080/0886022x.2018.1532908
Popis: Objective: The association between poor intraoperative glycemic control and postoperative acute kidney injury (AKI) in adult cardiac surgery has been observed, but data in the pediatrics remain unknown. We performed a hypothesis that intraoperative hyperglycemia and/or wider glycemic fluctuation were associated with the incidence of postoperative AKI in pediatric cardiac surgery. Methods: A retrospective study was performed in pediatrics who underwent cardiac surgery from 2013 to 2016. Perioperative glycemic data up to 48 hours after surgery were collected and analyzed. Patients with AKI were matched 1:1 with patients without AKI by a propensity score. Variables of demographic data, preoperative renal function and glycemic level, perioperative cardiac condition were matched. Results: The incidence of AKI was 11.5% (118/1026), with 53.4% (63/118), 30.5% (36/118), and 16.1% (19/118) categorized as AKIN stages I, II, and III, respectively. Children who experienced AKI were younger and cyanotic, underwent more complex surgeries, had higher peak intraoperative glucose levels, wider intraoperative glycemic fluctuation, greater inotropic scores and more transfusions, and poor outcomes (all p
Databáze: OpenAIRE
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