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Acute kidney injury (AKI) has been recognized as a typical post- operative complication among the children undergoing surgical repair of a congenital cardiac defect. It is associated with increased morbidity and mortality in the intensive care unit and a higher utilization of hospital resources. However, how to precisely identify those who have greater hazard to encounter postoperative AKI seems ambiguous.
The development of AKI is common following cardiac surgery whether in adult or pediatric population. Not only severe AKI like dialysis support, but also mild kidney injury has profound influence on increased subsequent morbidities and mortality.
Pediatric patients who undergo cardiac procedures are characterized by lower weight, younger age, complicated cardiac anomaly and poor resistance to surgical insults. Thus, in comparison with adults, their AKI risk is relatively higher.
At present there has been no specific intervention regarding AKI prevention and therapy. Establishing a risk score based on patient characteristics and surgical information to effectively predict postoperative AKI risk is therefore imperative. It can serve as a decision-making tool to facilitate patient management with regard to kidney prognosis.
This program is aimed at developing and internally validating a AKI risk score post cardiac surgery in a Chinese pediatric population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AKI | AKI is defined by KDIGO criterion based on peri-operative serum creatinine variation. |
| |
| No-AKI | No-AKI is defined by KDIGO criterion based on peri-operative serum creatinine variation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention | Other | No intervention |
|
| Measure | Description | Time Frame |
|---|---|---|
| The Prevalence of Acute Kidney Injury | Acute Kidney Injury was defined by Kidney Disease Improving Global Outcomes (KDIGO) Criteria. Accordingly, AKI was classified as stage 1, stage 2 and stage 3. | Up to postoperative 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of dialysis | The therapeutic approach to correct renal failure | Up to postoperative 7 days |
| The hours of mechanical ventilation | Time before first extubation |
| Measure | Description | Time Frame |
|---|---|---|
| The relative change of left ventricular ejection fraction (LVEF) from baseline to postoperative 1 year | (LVEF at 1 year - LVEF at baseline)/LVEF at baseline * 100% | Up to postoperative 1 year |
| The relative change of left ventricular end-diastolic diameter (LVEDD) from baseline to postoperative 1 year |
Inclusion Criteria:
Exclusion Criteria:
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A cohort of pediatric patients of 18 years old and younger who have cardiac procedures in Fuwai Hospital, Beijing, China will be consecutively enrolled.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jianhui Wang, MD | Contact | +86-010-88398082; | stewenwang@sina.com |
| Name | Affiliation | Role |
|---|---|---|
| Jianhui Wang, MD | Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medial Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fuwai Hospital | Recruiting | Beijing | Beijing Municipality | 100037 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39021216 | Derived | Bie D, Li Y, Wang H, Liu Q, Dou D, Jia Y, Yuan S, Li Q, Wang J, Yan F. Relationship between intra-operative urine output and postoperative acute kidney injury in paediatric cardiac surgery: A retrospective observational study. Eur J Anaesthesiol. 2024 Dec 1;41(12):881-888. doi: 10.1097/EJA.0000000000002044. Epub 2024 Aug 16. |
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IPD cannot be shared with other researchers. However, data can be provided if requested.
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| ID | Term |
|---|---|
| D006330 | Heart Defects, Congenital |
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D018376 | Cardiovascular Abnormalities |
| D002318 | Cardiovascular Diseases |
| D006331 | Heart Diseases |
| D000013 | Congenital Abnormalities |
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| Up to postoperative 7 days |
| The incidence of reinbutation | Need for postoperative endotracheal intubation given the occurrence of respiratory or non-respiratory complication after extubation. | Up to hospital discharge, an average of 7 days |
| The incidence of tracheotomy | The necessary treatment for postoperative respiratory failure | Up to hospital discharge, an average of 7 days |
| The incidence of re-operation | Re-exploration prescribed by surgeons due to cardiac issues or excessive chest drainage volume. | Up to hospital discharge, an average of 7 days |
| The incidence of mechanical cardiac support | Supported by extracorporeal membrane oxygenation from operative day to discharge or death | Up to hospital discharge, an average of 7 days |
| The incidence of mortality | Specific death reason | Up to hospital discharge, an average of 7 days |
| The incidence of pulmonary infection | Assessed by relevant guidelines of pulmonary infection | Up to hospital discharge, an average of 7 days |
| The cost of medical resources | The RMB patients spend during the whole hospitalization | Up to hospital discharge, an average of 7 days |
| Intensive Care Unit Discharge Time | Time and date when the patient is transferred to ward | Up to ICU discharge, an average of 5 days |
| Hospital Discharge Time | Time and date when the patient is discharged from the hospital | Up to hospital discharge, an average of 7 days |
| The relative change of left ventricular ejection fraction (LVEF) from baseline to hospital discharge | (LVEF at hospital discharge - LVEF at baseline)/LVEF at baseline * 100% | Up to hospital discharge, an average of 7 days |
| The relative change of left ventricular end-diastolic diameter (LVEDD) from baseline to hospital discharge | (LVEDD at hospital discharge - LVEDD at baseline)/LVEDD at baseline * 100% | Up to hospital discharge, an average of 7 days |
(LVEDD at 1 year - LVEDD at baseline)/LVEDD at baseline * 100% |
| Up to postoperative 1 year |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |