Acute Kidney Injury in Asphyxiated Newborns Treated with Therapeutic Hypothermia

To test the hypothesis that acute kidney injury (AKI) would be independently associated with increased morbidity and mortality. A total of 96 consecutively cooled infants were reviewed retrospectively. Modified Acute Kidney Injury Network criteria were used to classify AKI based on absolute rise in...

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Veröffentlicht in:The Journal of pediatrics Jg. 162; H. 4; S. 725 - 729.e1
Hauptverfasser: Selewski, David T., Jordan, Brian K., Askenazi, David J., Dechert, Ronald E., Sarkar, Subrata
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Inc 01.04.2013
Mosby, Inc
Schlagworte:
Acute Kidney Injury
Acute Kidney Injury - etiology
adverse effects
Asphyxia Neonatorum
Asphyxia Neonatorum - complications
Asphyxia Neonatorum - therapy
blood
blood serum
complications
creatinine
Creatinine - blood
dialysis
etiology
Female
Humans
hypothermia
Hypothermia, Induced
Hypothermia, Induced - adverse effects
Infant, Newborn
Intensive Care, Neonatal
Intensive Care, Neonatal - methods
kidneys
Length of Stay
Male
methods
morbidity
mortality
Multivariate Analysis
neonates
patients
Pediatrics
Respiration, Artificial
Retrospective Studies
therapy
Time Factors
Treatment Outcome
AKIN
NICU
SCr
AKI
Acute Kidney Injury Network
Neonatal intensive care unit
Acute kidney injury
Serum creatinine
ISSN:0022-3476, 1097-6833, 1097-6833
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Zusammenfassung:To test the hypothesis that acute kidney injury (AKI) would be independently associated with increased morbidity and mortality. A total of 96 consecutively cooled infants were reviewed retrospectively. Modified Acute Kidney Injury Network criteria were used to classify AKI based on absolute rise in serum creatinine (SCr) level from a previous trough (stage I, rise in SCr of 0.3 mg/dL or SCr 150-<200%; stage II, rise in SCr of 200-<300%; stage III, rise in SCr of ≥300%, SCr 2.5 mg/dL, or dialysis). Outcomes were mortality, duration of neonatal intensive care unit (NICU) stay, and duration of mechanical ventilation. AKI occurred in 36 of 96 infants (38%). Overall mortality was 7% and was higher for those with AKI, with the difference approaching statistical significance (14% vs 3% in those without AKI; P = .099). Patients with AKI stayed longer in the NICU (mean, 15.4 ± 9.3 days vs 11 ± 5.9 days; P = .014) and required prolonged mechanical ventilation (mean, 9.7 ± 5.9 days vs 4.8 ± 3.7 days; P < .001). On multivariate analysis, AKI remained predictive of prolonged duration of mechanical ventilation and prolonged NICU stay. We used the Acute Kidney Injury Network definition for AKI in asphyxiated newborns undergoing therapeutic hypothermia to demonstrate that the incidence of AKI remains high, but lower than rates published before the advent of therapeutic hypothermia. We highlight the importance of recognizing AKI in asphyxiated newborns undergoing therapeutic hypothermia, along with the potential benefits of early recognition.
Bibliographie:http://dx.doi.org/10.1016/j.jpeds.2012.10.002
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0022-3476
1097-6833
1097-6833
DOI:10.1016/j.jpeds.2012.10.002