Key result
Congenital heart surgery carries a 6.5% AKI incidence, associated with prolonged CPB and hypotension.
Why the study?
The incidence and risk factors for acute kidney injury in children with congenital heart disease undergoing cardiac surgery were not well defined in this setting.
What is the incidence and what are the risk factors for acute kidney injury in patients with congenital heart disease undergoing cardiac surgery?
Cross-Sectional (n=93)
No
What is the incidence and what are the risk factors for acute kidney injury in patients with congenital heart disease undergoing cardiac surgery?
Post-operative acute kidney injury occurred in 6.5% of patients undergoing congenital heart disease surgery and was strongly associated with prolonged cardiopulmonary bypass time, hypotension, and increased mortality.
Answers are grounded in this paper and cite their sources.
AKI incidence and risk factors after pediatric CHD surgery quantified; leaves open whether findings warrant targeted prevention trials.
Objective: To determine the incidence and risk factors associated with acute kidney injury (AKI) in children with congenital heart diseases (CHDs) who underwent cardiac surgery in a tertiary care center. Study Design: Cross-sectional study. Setting: Paediatric Cardiac Intensive Care Unit (PCICU) of National Institute of Cardiovascular diseases, Karachi, Pakistan. Period: November 2022 to May 2023. Material & Methods: We included patients of both genders and any age who underwent open or closed heart surgery for congenital heart defects. All patients undergoing CHD repairs were monitored for the total duration of PCICU stay. The development of AKI was labeled as per RIFLE criteria, and management thereafter was performed as per standard institutional protocols. Results: In a total of 93 patients with CHD, there were 50 (53.8%) males and 43 (46.2%) females. The mean age was 9.71±9.14 year ranging between 3 months to 60 years. There were 6 (6.5%) patients who developed AKI post-surgery. Overall, mortality was noted in 7 (7.5%) patients. Cardiopulmonary bypass (CPB) time and aortic cross-clamp (ACC) time were significantly higher among patients who developed post-surgery AKI (<0.001). Moreover, post-surgery AKI was significantly associated with intra-operative hypotension (p<0.001), post-operative hypotension (p<0.001), and post-operative sepsis (p<0.001). It was also found that AKI had significant association with higher post-operative inotropic scores (p<0.001), prolonged duration of mechanical ventilation (p<0.001), and length of PCICU stay (p<0.001). Mortality had significant association with AKI (33.3% vs. 5.7%, p=0.013). Conclusion: We noted the incidence of AKI among patient who underwent cardiac repairs to be 6.5%. CPB time and ACC time were significantly higher among patients who developed post-surgery AKI. Post-surgery AKI was significantly associated with intra-operative hypotension, post-operative hypotension, and post-operative sepsis. Mortality was significant high among cases that had AKI.
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Khokhar et al. (2023) conducted a cross-sectional in Congenital heart disease (n=93). Cardiac surgery for congenital heart disease was evaluated on Incidence of acute kidney injury (AKI). The incidence of acute kidney injury following cardiac surgery for congenital heart disease was 6.5%, with significant risk factors including prolonged cardiopulmonary bypass time and hypotension.
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