Intraoperative Transfusion of Autologous Blood Protects from Acute Kidney Injury after Pediatric Congenital Heart Surgery
Background: Acute kidney injury (AKI) is a common complication after pediatric cardiac surgery. And autologous blood transfusion (ABT) is an important predictor of postoperative AKI. Unlike previous studies, which mainly focused on the correlation between ABT and AKI, the current study focuses heavi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2023-11-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/24/11/10.31083/j.rcm2411331 |
| _version_ | 1797400703241551872 |
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| author | Yuhan Sun Xian Zeng Shanshan Shi Zhuo Shi Ting Huang Yong Fan Yuqing Feng Xudong Lu Huilong Duan Xiangming Fan Qiang Shu Haomin Li |
| author_facet | Yuhan Sun Xian Zeng Shanshan Shi Zhuo Shi Ting Huang Yong Fan Yuqing Feng Xudong Lu Huilong Duan Xiangming Fan Qiang Shu Haomin Li |
| author_sort | Yuhan Sun |
| collection | DOAJ |
| description | Background: Acute kidney injury (AKI) is a common complication after pediatric cardiac surgery. And autologous blood transfusion (ABT) is an important predictor of postoperative AKI. Unlike previous studies, which mainly focused on the correlation between ABT and AKI, the current study focuses heavily on the causal relationship between them, thus providing guidance for the treatment of patients during hospitalization to reduce the occurrence of AKI. Methods: A retrospective cohort of 3386 patients extracted from the Pediatric Intensive Care database was used for statistical analysis, multifactorial analysis, and causal inference. Characteristics that were correlated with ABT and AKI were categorized as confounders, instrumental variables, and effect modifiers, and were entered into the DoWhy causal inference model to determine causality. The calculated average treatment effect (ATE) was compared with the results of the multifactorial analysis. Results: The adjusted odds ratio (OR) for ABT volume was obtained by multifactorial analysis as 0.964. The DoWhy model refute test was able to indicate a causal relationship between ABT and AKI. Any ABT reduces AKI about 15.3%–18.8% by different estimation methods. The ATE regarding the amount of ABT was –0.0088, suggesting that every 1 mL/kg of ABT reduced the risk of AKI by 0.88%. Conclusions: Intraoperative transfusion of autologous blood can have a protective effect against postoperative AKI. |
| first_indexed | 2024-03-09T01:59:19Z |
| format | Article |
| id | doaj.art-09b2c1ca5fef499b961b13f6cb0f7b72 |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-03-09T01:59:19Z |
| publishDate | 2023-11-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-09b2c1ca5fef499b961b13f6cb0f7b722023-12-08T06:09:21ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-11-01241133110.31083/j.rcm2411331S1530-6550(23)01033-5Intraoperative Transfusion of Autologous Blood Protects from Acute Kidney Injury after Pediatric Congenital Heart SurgeryYuhan Sun0Xian Zeng1Shanshan Shi2Zhuo Shi3Ting Huang4Yong Fan5Yuqing Feng6Xudong Lu7Huilong Duan8Xiangming Fan9Qiang Shu10Haomin Li11Clinical Data Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 310052 Hangzhou, Zhejiang, ChinaThe College of Biomedical Engineering and Instrument Science, Zhejiang University, 310027 Hangzhou, Zhejiang, ChinaCICU, Children's Hospital, Zhejiang University School of Medicine, 310052 Hangzhou, Zhejiang, ChinaCardiac Surgery,Children's Hospital, Zhejiang University School of Medicine, 310052 Hangzhou, Zhejiang, ChinaCardiac Surgery,Children's Hospital, Zhejiang University School of Medicine, 310052 Hangzhou, Zhejiang, ChinaCPB/ECMO Children's Hospital, Zhejiang University School of Medicine, 310052 Hangzhou, Zhejiang, ChinaClinical Data Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 310052 Hangzhou, Zhejiang, ChinaThe College of Biomedical Engineering and Instrument Science, Zhejiang University, 310027 Hangzhou, Zhejiang, ChinaThe College of Biomedical Engineering and Instrument Science, Zhejiang University, 310027 Hangzhou, Zhejiang, ChinaCardiac Surgery,Children's Hospital, Zhejiang University School of Medicine, 310052 Hangzhou, Zhejiang, ChinaCardiac Surgery,Children's Hospital, Zhejiang University School of Medicine, 310052 Hangzhou, Zhejiang, ChinaClinical Data Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 310052 Hangzhou, Zhejiang, ChinaBackground: Acute kidney injury (AKI) is a common complication after pediatric cardiac surgery. And autologous blood transfusion (ABT) is an important predictor of postoperative AKI. Unlike previous studies, which mainly focused on the correlation between ABT and AKI, the current study focuses heavily on the causal relationship between them, thus providing guidance for the treatment of patients during hospitalization to reduce the occurrence of AKI. Methods: A retrospective cohort of 3386 patients extracted from the Pediatric Intensive Care database was used for statistical analysis, multifactorial analysis, and causal inference. Characteristics that were correlated with ABT and AKI were categorized as confounders, instrumental variables, and effect modifiers, and were entered into the DoWhy causal inference model to determine causality. The calculated average treatment effect (ATE) was compared with the results of the multifactorial analysis. Results: The adjusted odds ratio (OR) for ABT volume was obtained by multifactorial analysis as 0.964. The DoWhy model refute test was able to indicate a causal relationship between ABT and AKI. Any ABT reduces AKI about 15.3%–18.8% by different estimation methods. The ATE regarding the amount of ABT was –0.0088, suggesting that every 1 mL/kg of ABT reduced the risk of AKI by 0.88%. Conclusions: Intraoperative transfusion of autologous blood can have a protective effect against postoperative AKI.https://www.imrpress.com/journal/RCM/24/11/10.31083/j.rcm2411331acute kidney injurycausal inferencemulti-factor analysispediatric cardiac surgerytreatment effect evaluation |
| spellingShingle | Yuhan Sun Xian Zeng Shanshan Shi Zhuo Shi Ting Huang Yong Fan Yuqing Feng Xudong Lu Huilong Duan Xiangming Fan Qiang Shu Haomin Li Intraoperative Transfusion of Autologous Blood Protects from Acute Kidney Injury after Pediatric Congenital Heart Surgery Reviews in Cardiovascular Medicine acute kidney injury causal inference multi-factor analysis pediatric cardiac surgery treatment effect evaluation |
| title | Intraoperative Transfusion of Autologous Blood Protects from Acute Kidney Injury after Pediatric Congenital Heart Surgery |
| title_full | Intraoperative Transfusion of Autologous Blood Protects from Acute Kidney Injury after Pediatric Congenital Heart Surgery |
| title_fullStr | Intraoperative Transfusion of Autologous Blood Protects from Acute Kidney Injury after Pediatric Congenital Heart Surgery |
| title_full_unstemmed | Intraoperative Transfusion of Autologous Blood Protects from Acute Kidney Injury after Pediatric Congenital Heart Surgery |
| title_short | Intraoperative Transfusion of Autologous Blood Protects from Acute Kidney Injury after Pediatric Congenital Heart Surgery |
| title_sort | intraoperative transfusion of autologous blood protects from acute kidney injury after pediatric congenital heart surgery |
| topic | acute kidney injury causal inference multi-factor analysis pediatric cardiac surgery treatment effect evaluation |
| url | https://www.imrpress.com/journal/RCM/24/11/10.31083/j.rcm2411331 |
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