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Predictors of Acute Renal Failure During Extracorporeal Membrane Oxygenation in Pediatric Patients After Cardiac Surgery
Author(s) -
Lv Lin,
Long Cun,
Liu Jinping,
Hei Feilong,
Ji Bingyang,
Yu Kun,
Hu Qiang,
Hu Jinxiao,
Yuan Yuan,
Gao Guodong
Publication year - 2016
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12644
Subject(s) - medicine , extracorporeal membrane oxygenation , interquartile range , cardiac surgery , univariate analysis , cardiopulmonary resuscitation , logistic regression , dialysis , cardiology , retrospective cohort study , creatinine , anesthesia , surgery , resuscitation , multivariate analysis
Acute renal failure ( ARF ) is associated with increased mortality in pediatric extracorporeal membrane oxygenation ( ECMO ). The aim of this study was to identify predictors of ARF during ECMO in pediatric patients after cardiac surgery. A retrospective study analyzed 42 children (≤15 years) after cardiac surgery requiring venous‐arterial ECMO between D ecember 2008 and D ecember 2014 at F uwai Hospital. ARF was defined as ≥300% rise in serum creatinine ( SCr ) concentration from baseline or application of dialysis. Multivariate logistic regression was performed to identify the predictors of ARF during ECMO . A total of 42 children (age, interquartile range [ IQR ], 13.0 [7.2–29.8] months; weight, IQR , 8.5 [6.7–11.0] kg) after cardiac surgery requiring ECMO were included in this study. The total survival rate was 52.4%, and the incidence of ARF was 40.5%. As the result of univariate analysis, ECMO duration, cardiopulmonary resuscitation, maximum free hemoglobin ( FHB ) during ECMO , lactate level, and mean blood pressure before initiation of ECMO were entered in multiple logistic regression analysis. In multiple logistic regression analysis, FHB during ECMO ( OR 1.136, 95% CI 1.023–1.261) and lactate level before initiation of ECMO ( OR 1.602, 95% CI 1.025–2.502) were risk factors for ARF during ECMO after pediatric cardiac surgery. There was a linear correlation between maximum SCr and maximum FHB ( P earson's r = 0.535, P = 0.001). Maximum SCr during ECMO has also a linear correlation with lactate level before initiation of ECMO ( P earson's r = 0.342, P = 0.044). Increased FHB during ECMO and high lactate level before initiation of ECMO were risk factors for ARF during ECMO in pediatric patients after cardiac surgery.