Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac Surgery
Acute kidney injury (AKI) is a common complication following cardiac surgery under cardiopulmonary bypass (CPB) in children. A prospective study for examining urinary neutrophil gelatinase-associated lipocalin (NGAL) and renal near-infrared spectroscopy (NIRS) trends during AKI was conducted among p...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/6/2085 |
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| author | Yoshihito Wakamatsu Keisuke Nakanishi Takanori Satoh Shiori Kawasaki Atsushi Amano |
| author_facet | Yoshihito Wakamatsu Keisuke Nakanishi Takanori Satoh Shiori Kawasaki Atsushi Amano |
| author_sort | Yoshihito Wakamatsu |
| collection | DOAJ |
| description | Acute kidney injury (AKI) is a common complication following cardiac surgery under cardiopulmonary bypass (CPB) in children. A prospective study for examining urinary neutrophil gelatinase-associated lipocalin (NGAL) and renal near-infrared spectroscopy (NIRS) trends during AKI was conducted among pediatric patients undergoing cardiac surgery with CPB. Urinary NGAL showed a significant difference between intensive care unit admission (0 h) and 2 h post-admission (<i>p</i> < 0.001) and remained significant up to 4 h (<i>p</i> < 0.05). The renal NIRS in the AKI group showed a significant rate of decrease and lower values during the intraoperative period (<i>p</i> < 0.05). The cumulative median saturation of renal regional saturation of oxygen (rSO<sub>2</sub>) during CPB was 1637.5% min in the AKI group and 943.0% min in the non-AKI group. The median renal rSO<sub>2</sub> scores at a reduction of 20% and 25% were significantly higher (<i>p</i> < 0.001) in the AKI group. Our results suggest that monitoring renal rSO<sub>2</sub> scores and limiting their decline might be useful in preventing AKI. The combination of NGAL, renal rSO<sub>2</sub>, and renal rSO<sub>2</sub> scores might be useful in the early diagnosis of AKI during pediatric cardiac surgery. |
| first_indexed | 2024-03-11T06:23:22Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T06:23:22Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-be57bd35f8584789b7b115199e0367002023-11-17T11:47:52ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01126208510.3390/jcm12062085Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac SurgeryYoshihito Wakamatsu0Keisuke Nakanishi1Takanori Satoh2Shiori Kawasaki3Atsushi Amano4Department of Clinical Engineering, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo 113-8431, JapanCardiology Department, Pediatric and Congenital Cardiac Surgery Division, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, JapanDepartment of Clinical Engineering, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo 113-8431, JapanCardiology Department, Pediatric and Congenital Cardiac Surgery Division, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, JapanCardiology Department, Pediatric and Congenital Cardiac Surgery Division, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, JapanAcute kidney injury (AKI) is a common complication following cardiac surgery under cardiopulmonary bypass (CPB) in children. A prospective study for examining urinary neutrophil gelatinase-associated lipocalin (NGAL) and renal near-infrared spectroscopy (NIRS) trends during AKI was conducted among pediatric patients undergoing cardiac surgery with CPB. Urinary NGAL showed a significant difference between intensive care unit admission (0 h) and 2 h post-admission (<i>p</i> < 0.001) and remained significant up to 4 h (<i>p</i> < 0.05). The renal NIRS in the AKI group showed a significant rate of decrease and lower values during the intraoperative period (<i>p</i> < 0.05). The cumulative median saturation of renal regional saturation of oxygen (rSO<sub>2</sub>) during CPB was 1637.5% min in the AKI group and 943.0% min in the non-AKI group. The median renal rSO<sub>2</sub> scores at a reduction of 20% and 25% were significantly higher (<i>p</i> < 0.001) in the AKI group. Our results suggest that monitoring renal rSO<sub>2</sub> scores and limiting their decline might be useful in preventing AKI. The combination of NGAL, renal rSO<sub>2</sub>, and renal rSO<sub>2</sub> scores might be useful in the early diagnosis of AKI during pediatric cardiac surgery.https://www.mdpi.com/2077-0383/12/6/2085acute kidney injurycardiopulmonary bypassneutrophil gelatinase-associated lipocalinnear-infrared spectroscopyregional saturation of oxygenpediatric cardiac surgery |
| spellingShingle | Yoshihito Wakamatsu Keisuke Nakanishi Takanori Satoh Shiori Kawasaki Atsushi Amano Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac Surgery Journal of Clinical Medicine acute kidney injury cardiopulmonary bypass neutrophil gelatinase-associated lipocalin near-infrared spectroscopy regional saturation of oxygen pediatric cardiac surgery |
| title | Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac Surgery |
| title_full | Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac Surgery |
| title_fullStr | Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac Surgery |
| title_full_unstemmed | Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac Surgery |
| title_short | Use of Renal Near-Infrared Spectroscopy and Urinary Neutrophil Gelatinase-Associated Lipocalin Monitoring as Indicators of Acute Kidney Injury in Pediatric Cardiac Surgery |
| title_sort | use of renal near infrared spectroscopy and urinary neutrophil gelatinase associated lipocalin monitoring as indicators of acute kidney injury in pediatric cardiac surgery |
| topic | acute kidney injury cardiopulmonary bypass neutrophil gelatinase-associated lipocalin near-infrared spectroscopy regional saturation of oxygen pediatric cardiac surgery |
| url | https://www.mdpi.com/2077-0383/12/6/2085 |
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