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Acute kidney injury is associated with subsequentinfection in neonates after the Norwood procedure: a retrospective chart review

Acute kidney injury is associated with subsequentinfection in neonates after the Norwood... Background Acute kidney injury (AKI) and infection are common complications after pediatric cardiac surgery. No pediatric study has evaluated for an association between postoperative AKI and infection. The objective of this study was to determine if AKI in neonates after cardiopulmonary bypass was associated with the development of a postoperative infection. Methods We performed a single center retrospective chart review from January 2009 to December 2015 of neonates (age ≤ 30 days) undergoing the Norwood procedure. AKI was defined by the modified neonatal Kidney Disease Improving Global outcomes serum creatinine criteria using (1) measured serum creatinine and (2) creatinine corrected for fluid balance on postoperative days 1–4. Infection, (culture positive or presumed), must have occurred after a diagnosis of AKI and within 60 days of surgery. Results Ninety-five patients were included, of which postoperative infection occurred in 42 (44%). AKI occurred in 38 (40%) and 42 (44%) patients by measured serum creatinine and fluid overload corrected creatinine, respectively, and was most commonly diagnosed on postoperative day 2. The median time to infection from the time of surgery and AKI was 7 days (IQR 5–14 days) and 6 days (IQR 3–13 days), respectively. After adjusting for confounders, the odds of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Nephrology Springer Journals

Acute kidney injury is associated with subsequentinfection in neonates after the Norwood procedure: a retrospective chart review

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Publisher
Springer Journals
Copyright
Copyright © 2018 by IPNA
Subject
Medicine & Public Health; Pediatrics; Nephrology; Urology
ISSN
0931-041X
eISSN
1432-198X
DOI
10.1007/s00467-018-3907-5
Publisher site
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Abstract

Background Acute kidney injury (AKI) and infection are common complications after pediatric cardiac surgery. No pediatric study has evaluated for an association between postoperative AKI and infection. The objective of this study was to determine if AKI in neonates after cardiopulmonary bypass was associated with the development of a postoperative infection. Methods We performed a single center retrospective chart review from January 2009 to December 2015 of neonates (age ≤ 30 days) undergoing the Norwood procedure. AKI was defined by the modified neonatal Kidney Disease Improving Global outcomes serum creatinine criteria using (1) measured serum creatinine and (2) creatinine corrected for fluid balance on postoperative days 1–4. Infection, (culture positive or presumed), must have occurred after a diagnosis of AKI and within 60 days of surgery. Results Ninety-five patients were included, of which postoperative infection occurred in 42 (44%). AKI occurred in 38 (40%) and 42 (44%) patients by measured serum creatinine and fluid overload corrected creatinine, respectively, and was most commonly diagnosed on postoperative day 2. The median time to infection from the time of surgery and AKI was 7 days (IQR 5–14 days) and 6 days (IQR 3–13 days), respectively. After adjusting for confounders, the odds of

Journal

Pediatric Nephrology – Springer Journals

Published: Mar 5, 2018

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