Acute Kidney Injury
Conditions
Keywords
Acute Kidney Injury, Cardiac Surgery, Cardiopulmonary Bypass, Congenital Heart Disease, Biomarkers
Brief summary
Acute kidney injury (AKI) is a common complication after surgery for congenital heart disease and is associated with significant morbidity and mortality. To-date, no biomarker has been universally implemented for predicting AKI in neonates after cardiac surgery. In this study, the use of hematological ratios will be evaluated for predicting AKI and postoperative outcomes in this patient cohort.
Detailed description
In adults, hematological ratios which can be calculated from a routinely ordered complete blood count with differential, such as the neutrophil/lymphocyte ratio, have been demonstrated to be correlated with acute kidney injury (AKI) and other clinical outcomes after cardiovascular surgery. In this retrospective observational study, the association between hematological ratios (neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, neutrophil/lymphocyte\*platelet ratio, monocyte/lymphocyte ratio, and plateletcrit) and postoperative AKI, morbidity (length of ICU stay, hospital stay, mechanical ventilation, vasoactive infusion-free days, etc.) and mortality will be evaluated in neonates who underwent cardiac surgery with cardiopulmonary bypass.
Interventions
PROCEDURECardiac Surgery with Cardiopulmonary Bypass
Cardiac Surgery with Cardiopulmonary Bypass
Sponsors
Children's Hospital Medical Center, Cincinnati
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Days to 31 Days
Healthy volunteers
No
Inclusion criteria
* Neonates (≤31 days) who underwent cardiac surgery with cardiopulmonary bypass for congenital heart disease.
Exclusion criteria
* Patients with missing relevant preoperative or postoperative data points * Patients with previous palliation or reoperation, * Thymus hypo/aplasia (DiGeorge Syndrome, Ataxia-telangiectasia, or Nezelof syndrome), * Primary immunodeficiency, * Episode of cardiac arrest within 1 week before surgery, * Signs or history of preoperative renal impairment or AKI (KDIGO Stage ≥1 observed on preoperative labs), * Hypothyroidism, * Patients with a history of infection within a week prior to surgery or antibiotics administered within the first 3 days after surgery (except for postoperative antibiotics).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acute Kidney Injury (AKI) | up to 72 hours postoperative | Occurrence of AKI as defined by the Kidney Disease Improving Global Outcomes (KDIGO) diagnostic classification (using serum creatinine) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 1-year mortality | up to 1 year postoperative | Mortality within 1 year after surgery (rate) |
| Length of hospital stay | up to 1 year postoperative | Total length of hospital stay (days) |
| Length of Cardiac Intensive Care Unit (CICU) Stay | up to 1 year postoperative | Total length of stay in the CICU (days) |
| Operative Mortality | up to 30 days postoperative | Mortality within 30 days after surgery (rate) |
| Vasoactive infusion-free days | up to 28 days postoperative | (days) |
| Postoperative infection | up to 3 days postoperative | Occurrence of infection defined as: antibiotic use (other than perioperative) within 3 days postop, positive blood culture within 3 days postop, positive viral panel within 3 days postop |
| Low Cardiac Output Syndrome | up to 2 days postoperative | Occurrence of Low Cardiac Output Syndrome defined as any of the following at any time during the first 48 hours postoperative: 1. Lactate \>6mmol/l and mixed venous saturation (ScvO2) \<60% (or SaO2-ScvO2 difference greater than 35% in a single ventricle), 2. Vasoactive inotropic score (VIS)3 ≥ 10, 3. Extracorporeal Membrane Oxygenation (ECMO |
| Length of mechanical ventilation | up to 1 year postoperative | Total length of postoperative mechanical ventilator support (days) |
Countries
United States
Outcome results
None listed