婴幼儿先天性心脏病术后急性肾损伤和液体超负荷相关危险因素分析

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Abstract Objective To investigate the clinical risk factors of acute kidney injury (AKI) and fluid overload (FOL) in infants after congenital heart disease (CHD) surgery. Methods Date of 95 patients aged ≤2 years underwent CPB surgery for CHD were reviewed retrospectively from May 2012 to May 2016. The serum creatinine level was recorded for 3 days after surgery. According to the AKIN standard of AKI, patients were divided into two groups: AKI group and non-AKI group. Preoperative, intraoperative and postoperative variables were collected and analyzed as the potential risk factors of AKI. Percentage FOL was recorded cumulatively at 24, 48, and 72 h after surgery. The influence of AKI and FOL on hospital length of stay, postoperative mechanical ventilation days, and mortality were analyzed. Results The incidence of infants AKI was 45%, of which 87% had AKI at stage I. Multivariate Logistic regression analysis showed factors association with cardiopulmonary bypass time, selective cerebral perfusion, preoperative creatinine value and vasoactive drugs score independently respectively (P < 0.05). A total of 8 patients died (5 cases of AKI of stage 1, 3 cases of AKI of stage 2). Single factor analysis showed that patients of the AKI group had longer hospital stay, ventilator days, and a higher mortality rate than the non- AKI group (P < 0.05). FOL of 62 infants were ≤15% in the first 72 h after surgery, FOL of 33 infants were ＞15%. Infants with FOL >15% had longer hospital stay, ventilator days, and a higher mortality rate than infants with FOL ≤15% FOL group (P < 0.05). Conclusion CPB duration, selective cerebral perfusion, preoperative creatinine value and vasoactive drugs score are relative risk factors of AKI after CHD surgery with CPB in infants. Postoperative AKI and FOL increased hospital stay, mechanical ventilation time and mortality.

Key words： Acute kidney injury Congenital heart disease Infants Heart surgery Fluid overload

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	DAI Wei LUO Deqiang CHEN Rui HUANG Lihua ZHU Zhigang

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DAI Wei LUO Deqiang CHEN Rui HUANG Lihua ZHU Zhigang. Analysis of risk factors of acute renal injury and fluid overload in infants after congenital heart disease surgery[J]. 中国医药导报, 2017, 14(17): 65-68.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I17/65

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