@article{4141e22c84564e4cb41a7cf01e2aaf3c,
title = "Epidemiology of Neonatal Acute Kidney Injury After Cardiac Surgery Without Cardiopulmonary Bypass",
abstract = "Background: The purpose of this Neonatal and Pediatric Heart and Renal Outcomes Network study was to describe the epidemiology and outcomes of cardiac surgery–associated acute kidney injury (CS-AKI) after cardiac surgery without cardiopulmonary bypass (non-CPB). Methods: We performed a retrospective study of neonates (≤30 days) who underwent non-CPB cardiac surgery at 22 centers affiliated with the Pediatric Cardiac Critical Care Consortium. CS-AKI was defined using the modified Kidney Disease: Improving Global Outcomes serum creatinine and urine output criteria from postoperative days 0 to 6. CS-AKI defined by serum creatinine was further subclassified into transient (resolved by postoperative day 3) and persistent/late (≥3 days). Multivariable regression analyses were used to determine risk factors for CS-AKI and associations with outcomes of ventilation hours and cardiac intensive care unit length of stay. Results: Five hundred eighty-two neonates (median age at surgery, 9 days [interquartile range, 5-15], 25% functional single ventricle] were included. CS-AKI occurred in 38.3%: Rate and severity varied across centers. Aggregate daily CS-AKI prevalence peaked on postoperative day 1 (17.1%). No stage of CS-AKI was associated with ventilation hours or length of stay. Persistent/late CS-AKI occurred in 48 patients (8%). Prostaglandin use and single-ventricle surgery were associated with persistent/late CS-AKI. Higher baseline serum creatinine but not persistent/late CS-AKI was associated with longer ventilation duration and intensive care unit length of stay after adjusting for confounders. Conclusions: Kidney Disease: Improving Global Outcomes–defined CS-AKI occurred commonly in neonates undergoing non-CPB cardiac surgery. However most CS-AKI was transient, and no CS-AKI classification was associated with worse outcomes. Further work is needed to determine the CS-AKI definition that best associates with outcomes in this cohort.",
author = "{NEPHRON Collaborative} and Jun Sasaki and Zahidee Rodriguez and Alten, {Jeffrey A.} and Rahman, {AKM Fazlur} and Garrett Reichle and Paul Lin and Mousumi Banerjee and David Selewski and Michael Gaies and Hock, {Kristal M.} and Santiago Borasino and Gist, {Katja M.} and Parthak Prodhan and Xiomara Garcia and Shannon Ramer and Mindy Sherman and Ghbeis, {Muhammad B.} and Clarke, {Shanelle A.} and Mary Lukacs and Dominic Zanaboni and {Sanchez de Toledo}, Joan and Domnina, {Yuliya A.} and Lucas Saenz and Tracy Baust and Jane Kluck and Linda Duncan and Koch, {Joshua D.} and Diddle, {J. Wesley} and Joshua Freytag and Amanda Harris and Hideat Abraha and John Butcher and Tadphale, {Sachin D.} and Krawczeski, {Catherine D.} and Kwiatkowski, {David M.} and Raymond, {Tia T.} and Burton, {Grant L.} and Ashima Das and Tajas Shan and Buckley, {Jason R.} and Luke Schroeder and Aanish Raees and Bradley Guidry and Sosa, {Lisa J.} and Bailly, {David K.} and Valentine, {Kevin M.} and Bhat, {Priya N.} and Neumayr, {Tara M.} and Afonso, {Natasha S.} and O'Neal, {Erika R.} and Lasa, {Javier J.} and Huskey, {Jordan L.} and Phillips, {Patrick A.} and Amy Ardisana and Kim Gonzalez and Eric Columb and Tammy Domar and Suzanne Viers",
note = "Funding Information: This work was supported, in part, by individual institutional departmental funds. Funding for this work was provided by a generous donation from Castin{\textquoteright} {\textquoteleft}N Catchin{\textquoteright} charity organization. The NEPHRON investigators are as follows: Parthak Prodhan, MD, Xiomara Garcia, MD, Shannon Ramer, BSN, RNC, Mindy Sherman, BSN, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas; Muhammad B. Ghbeis, MD, Division of Cardiovascular Critical Care, Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Shanelle A. Clarke, MD, Mary Lukacs, RN, BSN, Children's Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, Georgia; Dominic Zanaboni, MD, Division of Cardiac Critical Care Medicine, Department of Anesthesia/Critical Care, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Joan Sanchez de Toledo, MD, PhD, Yuliya A. Domnina, MD, Lucas Saenz, MD, Tracy Baust, BA, Department of Critical Care Medicine and Pediatrics, University of Pittsburg School of Medicine, Children's Hospital of Pittsburg of UPMC, Pittsburg, Pennsylvania; Jane Kluck, RN, BSN, Linda Duncan, RN, BSN, Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Joshua D. Koch, MD, Division of Critical Care Medicine, Department of Pediatrics, University of Texas Southwestern Medical School, Children's Medical Center of Dallas, Dallas, Texas; J. Wesley Diddle, MD, Department of Pediatrics, Children's National Medical Center, Washington, DC; Joshua Freytag, BS, Amanda Sammons, BS, Hideat Abraha, John Butcher, RN, BSN, Division of Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Sachin D. Tadphale, MD, Pediatric Cardiology, Pediatric Critical Care, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee; Catherine D. Krawczeski, MD, Lucile Packard Children's Hospital Stanford, Palo Alto, California and Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, Ohio; David M. Kwiatkowski, MD, Lucile Packard Children's Hospital Stanford, Palo Alto, California and Division of Nephrology, Division of Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California; Tia T. Raymond, MD, Grant L. Burton, MD, Ashima Das, MD, Tajas Shan, MD, Department of Pediatric Cardiology, Medical City Children's Hospital, Dallas, Texas; Jason R. Buckley, MD, Luke Schroeder, MD, Medical University of South Carolina Children's Hospital, Charleston, South Carolina; Aanish Raees, MBBS, Bradley Guidry, BS, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee; Lisa J. Sosa, ARNP, Nicklaus Children's Hospital, Miami, Florida; David K. Bailly, DO, Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Primary Children's Hospital, Salt Lake City, Utah; Kevin M. Valentine, MD, Division of Critical Care, Department of Pediatrics, Indiana University School of Medicine, Riley Children's Hospital, Indianapolis, Indiana; Priya N. Bhat, MD, MS, St Louis Children's Hospital, St Louis, Missouri and Division of Pediatric Critical Care, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; Tara M. Neumayr, MD, St Louis Children's Hospital, St Louis and Division of Pediatric Critical Care Medicine and Division of Pediatric Nephrology, Department of Pediatrics, Washington University of St Louis, St Louis, Missouri; Natasha S. Afonso, MD, MPH, Erika R. O'Neil, MD, Javier J Lasa, MD, Pediatric Critical Care, Baylor College of Medicine, Houston and Children's Hospital, Houston, Texas; Jordan L. Huskey, BS, Patrick A. Phillips, University of Alabama at Birmingham, Children's Hospital of Alabama, Birmingham, Alabama; Amy Ardisana, MPH, Arbormetrix, Ann Arbor, Michigan; Kim Gonzalez, MS, CCRP, Eric Columb, BS, Tammy Domar, BS, Suzanne Viers, BS, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan. Publisher Copyright: {\textcopyright} 2022 The Society of Thoracic Surgeons",
year = "2022",
month = nov,
doi = "10.1016/j.athoracsur.2021.09.032",
language = "English",
volume = "114",
pages = "1786--1792",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
number = "5",
}