Acute Kidney Injury, Congenital Heart Disease, Surgery--Complications
Conditions
Keywords
Pediatric Cardiac Surgery, Acute Kidney Injury, Prediction
Brief summary
Acute kidney injury (AKI) has been recognized as a typical post- operative complication among the children undergoing surgical repair of a congenital cardiac defect. It is associated with increased morbidity and mortality in the intensive care unit and a higher utilization of hospital resources. However, how to precisely identify those who have greater hazard to encounter postoperative AKI seems ambiguous.
Detailed description
The development of AKI is common following cardiac surgery whether in adult or pediatric population. Not only severe AKI like dialysis support, but also mild kidney injury has profound influence on increased subsequent morbidities and mortality. Pediatric patients who undergo cardiac procedures are characterized by lower weight, younger age, complicated cardiac anomaly and poor resistance to surgical insults. Thus, in comparison with adults, their AKI risk is relatively higher. At present there has been no specific intervention regarding AKI prevention and therapy. Establishing a risk score based on patient characteristics and surgical information to effectively predict postoperative AKI risk is therefore imperative. It can serve as a decision-making tool to facilitate patient management with regard to kidney prognosis. This program is aimed at developing and internally validating a AKI risk score post cardiac surgery in a Chinese pediatric population.
Interventions
OTHERNo intervention
No intervention
Sponsors
China National Center for Cardiovascular Diseases
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Days to 18 Years
Healthy volunteers
No
Inclusion criteria
1. \< 18 years old 2. Pediatric patients undergoing cardiac surgery in Fuwai Hospital
Exclusion criteria
1. Supported by dialysis for renal failure prior to cardiac procedure 2. Previously received a renal transplant 3. Lack of preoperative or postoperative serum creatinine measurements 4. Guardians' refusal on informed consent sign
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Prevalence of Acute Kidney Injury | Up to postoperative 7 days | Acute Kidney Injury was defined by Kidney Disease Improving Global Outcomes (KDIGO) Criteria. Accordingly, AKI was classified as stage 1, stage 2 and stage 3. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of re-operation | Up to hospital discharge, an average of 7 days | Re-exploration prescribed by surgeons due to cardiac issues or excessive chest drainage volume. |
| The incidence of pulmonary infection | Up to hospital discharge, an average of 7 days | Assessed by relevant guidelines of pulmonary infection |
| The incidence of mechanical cardiac support | Up to hospital discharge, an average of 7 days | Supported by extracorporeal membrane oxygenation from operative day to discharge or death |
| The incidence of dialysis | Up to postoperative 7 days | The therapeutic approach to correct renal failure |
| The hours of mechanical ventilation | Up to postoperative 7 days | Time before first extubation |
| The incidence of reinbutation | Up to hospital discharge, an average of 7 days | Need for postoperative endotracheal intubation given the occurrence of respiratory or non-respiratory complication after extubation. |
| The incidence of tracheotomy | Up to hospital discharge, an average of 7 days | The necessary treatment for postoperative respiratory failure |
| The relative change of left ventricular ejection fraction (LVEF) from baseline to hospital discharge | Up to hospital discharge, an average of 7 days | (LVEF at hospital discharge - LVEF at baseline)/LVEF at baseline \* 100% |
| The relative change of left ventricular end-diastolic diameter (LVEDD) from baseline to hospital discharge | Up to hospital discharge, an average of 7 days | (LVEDD at hospital discharge - LVEDD at baseline)/LVEDD at baseline \* 100% |
| The incidence of mortality | Up to hospital discharge, an average of 7 days | Specific death reason |
| The cost of medical resources | Up to hospital discharge, an average of 7 days | The RMB patients spend during the whole hospitalization |
| Intensive Care Unit Discharge Time | Up to ICU discharge, an average of 5 days | Time and date when the patient is transferred to ward |
| Hospital Discharge Time | Up to hospital discharge, an average of 7 days | Time and date when the patient is discharged from the hospital |
Other
| Measure | Time frame | Description |
|---|---|---|
| The relative change of left ventricular ejection fraction (LVEF) from baseline to postoperative 1 year | Up to postoperative 1 year | (LVEF at 1 year - LVEF at baseline)/LVEF at baseline \* 100% |
| The relative change of left ventricular end-diastolic diameter (LVEDD) from baseline to postoperative 1 year | Up to postoperative 1 year | (LVEDD at 1 year - LVEDD at baseline)/LVEDD at baseline \* 100% |
Countries
China
Contacts
Primary ContactJianhui Wang, MD
Outcome results
None listed