Association Between Exogenous Nitric Oxide Given During Cardiopulmonary Bypass and the Incidence of Postoperative Kidney Injury in Children

Authors

Thoai A. Vuong, The George Washington University School of Medicine and Health Sciences, Division of Cardiac Anesthesia, Children's National Hospital, Washington, DC. Electronic address: tvuong@cnmc.org.
Md Sohel Rana, Children's National Hospital, Joseph E. Robert, Jr., Center for Surgical Care, Washington, DC.
Brenna Moore, The George Washington University School of Medicine and Health Sciences, MD Candidate, Washington, DC.
Jessica Cronin, The George Washington University School of Medicine and Health Sciences, Division of Anesthesia and Perioperative Medicine, Children's National Hospital, Washington, DC.
Nicolle M. Ceneri, The George Washington University School of Medicine and Health Sciences, MD Candidate, Washington, DC.
Pranava Sinha, The George Washington University School of Medicine and Health Sciences, Division of Cardiovascular Surgery, Children's National Hospital, Washington, DC.
Nina Deutsch, The George Washington University School of Medicine and Health Sciences, Division of Cardiac Anesthesia, Children's National Hospital, Washington, DC.
Andrew J. Matisoff, The George Washington University School of Medicine and Health Sciences, Division of Cardiac Anesthesia, Children's National Hospital, Washington, DC.

Document Type

Journal Article

Publication Date

8-1-2022

Journal

Journal of cardiothoracic and vascular anesthesia

Volume

36

Issue

8 Pt A

DOI

10.1053/j.jvca.2021.10.007

Keywords

Pediatric cardiac surgery; acute kidney injury; cardiopulmonary bypass; nitric oxide; postoperative renal failure

Abstract

OBJECTIVE: To compare the incidence and severity of acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass and the administration of exogenous nitric oxide in children. DESIGN: A retrospective cohort study. SETTING: A single institution, university hospital. PARTICIPANTS: All children younger than 18 years of age who underwent surgery with cardiopulmonary bypass. INTERVENTIONS: Medical records of all eligible patients between January 4, 2017, and June 28, 2019, were reviewed. Patients were divided into two groups based on whether they received exogenous nitric oxide. MEASUREMENTS AND MAIN RESULTS: The primary endpoint was a change in serum creatinine level, defined as the difference between the preoperative creatinine and peak postoperative creatinine. The secondary endpoint was the incidence and severity of postoperative AKI. A difference-in-difference method using fixed-effect multiple linear regression was carried out to compare the difference in maximum serum creatinine changes between the control and intervention groups. Five hundred ninety-one patients were included in the analysis: 298 (50.5%) in the control group and 293 (49.5%) in the intervention group. Control and intervention groups did not vary significantly in terms of baseline characteristics except for bypass time. After adjusting for all baseline variables, there was no statistically significant difference in the increase in serum creatinine between the control and the intervention groups (0.01 [95% CI: -0.03, 0.05], p = 0.545). CONCLUSIONS: This single-center, retrospective, cohort study found no change in the incidence and severity of postoperative AKI after the administration of nitric oxide into the cardiopulmonary bypass circuit in children.

APA Citation

Vuong, Thoai A.; Rana, Md Sohel; Moore, Brenna; Cronin, Jessica; Ceneri, Nicolle M.; Sinha, Pranava; Deutsch, Nina; and Matisoff, Andrew J., "Association Between Exogenous Nitric Oxide Given During Cardiopulmonary Bypass and the Incidence of Postoperative Kidney Injury in Children" (2022). GW Authored Works. Paper 1547.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1547

Department

Pediatrics