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Identifying Risk for Acute Kidney Injury in Infants and Children Following Cardiac Arrest.

Tara M Neumayr1, Jeff Gill, Julie C Fitzgerald

  • 11Division of Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO. 2Division of Nephrology, Hypertension, and Pheresis, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO. 3Department of Surgery, Washington University School of Medicine, St. Louis, MO. 4Department of Political Science, Washington University School of Medicine, St. Louis, MO. 5Department of Biostatistics, Washington University School of Medicine, St. Louis, MO. 6Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 7Department of Neurology, Washington University School of Medicine, St. Louis, MO. 8Department of Pediatrics, University of Utah, Salt Lake City, UT. 9Division of Critical Care Medicine, Department of Pediatrics, CS Mott Children's Hospital, University of Michigan, Ann Arbor, MI. 10Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, MO.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|July 25, 2017
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Summary
This summary is machine-generated.

This study identified key risk factors for acute kidney injury in children after cardiac arrest, including epinephrine dosing, blood pressure, and chronic lung conditions. Understanding these factors may improve outcomes for pediatric cardiac arrest survivors.

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Area of Science:

  • Pediatric critical care medicine
  • Nephrology
  • Cardiology

Background:

  • Acute kidney injury (AKI) is a significant complication in pediatric cardiac arrest survivors.
  • Identifying modifiable risk factors is crucial for improving patient outcomes.
  • Previous research has not comprehensively evaluated AKI risk factors in this specific population.

Purpose of the Study:

  • To identify risk factors associated with the development of acute kidney injury in children who survive cardiac arrest.
  • To investigate the impact of specific clinical variables on AKI incidence and severity.

Main Methods:

  • Retrospective analysis of a public dataset from 15 children's hospitals within the Pediatric Emergency Care Applied Research Network.
  • Included 296 pediatric patients (1 day to 18 years) who experienced in-hospital or out-of-hospital cardiac arrest.
  • Utilized the Acute Kidney Injury Network criteria for AKI definition and an ordinal probit model for risk factor analysis.

Main Results:

  • Six critical risk factors for AKI were identified: total epinephrine doses, post-cardiac arrest blood pressure, arrest location, chronic lung condition, pH, and baseline creatinine.
  • Both the total number and rate of epinephrine doses significantly impacted AKI risk and severity.
  • Other identified factors included arrest location, baseline creatinine, and presence of a chronic lung condition.

Conclusions:

  • This study is the first to establish risk factors for AKI in pediatric cardiac arrest survivors.
  • Epinephrine dosing emerged as a significant factor, suggesting potential for epinephrine-induced kidney toxicity.
  • Identifying and potentially modifying these risk factors holds promise for reducing morbidity and mortality in this vulnerable patient group.