Identifying Risk for Acute Kidney Injury in Infants and Children Following Cardiac Arrest.
Identifying Risk for Acute Kidney Injury in Infants and Children Following Cardiac Arrest.
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DOI：
10.1097/pcc.0000000000001280
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发表时间：
2017-10
期刊：
影响因子：
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通讯作者：
Doctor A
中科院分区：
文献类型：
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作者：
Neumayr TM;Gill J;Fitzgerald JC;Gazit AZ;Pineda JA;Berg RA;Dean JM;Moler FW;Doctor A
Our goal was to identify risk factors for acute kidney injury (AKI) in children surviving cardiac arrest (CA). Retrospective analysis of a public-access dataset. Fifteen children’s hospitals associated with the Pediatric Emergency Care Applied Research Network. Two hundred ninety-six subjects between 1 day and 18 years of age who experienced in-hospital or out-of-hospital CA between July 1, 2003, and December 31, 2004. None. Our primary outcome was development of AKI as defined by the Acute Kidney Injury Network (AKIN) criteria. An ordinal probit model was developed. We found 6 critical explanatory variables, including total number of epinephrine doses, post-CA blood pressure, arrest location, presence of a chronic lung condition, pH, and presence of an abnormal baseline creatinine. Total number of epinephrine doses received as well as rate of epinephrine dosing impacted AKI risk and severity of AKI. This study is the first to identify risk factors for AKI in children after CA. Our findings regarding the impact of epinephrine dosing are of particular interest and suggest potential for epinephrine toxicity with regard to AKI. The ability to identify and potentially modify risk factors for AKI after CA may lead to improved morbidity and mortality in this population.
