Natural history of nonimmune‐mediated thrombocytopenia and acute kidney injury in pediatric open‐heart surgery

• DOI: 10.1111/pan.13063
• Publication Date: 2017-01-18T10:19:02Z
• Authors: Shannon Tew; Manuel L. Fontes; Nathaniel H. Greene; Miklos D. Kertai; George Ofori‐Amanfo; Robert D. B. Jaquiss; Andrew J. Lodge; Warwick A. Ames; Hercilia Mayumi Homi; Kelly A. Machovec; Edmund H. Jooste
• Keywords: Nadir

Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts AKI has not been investigated in population. Our objective was to investigate this examine independent predictors of AKI.After IRB approval, we performed a retrospective review institution's medical records database.This study at single institution over 5-year period.We included patients <21 years age undergoing CPB.Demographics, laboratory, surgical characteristics were captured, clinical event rates recorded.Descriptive statistics used evaluate creatinine distributions. T-tests chi-squared tests compare among Acute Kidney Injury Network groups. Multivariable logistic ordinal regression models determine association our predictor interest, count AKI.Eight hundred fourteen (23% infants 23% neonates) analysis. Postoperative decreased 48% from baseline reaching mean value 150 × 109 ·l-1 on day 3. occurred 37% including 13%, 17%, 6% stages 1, 2, 3, respectively. The magnitude correlated severity AKI. Independent include counts, CPB time, Aristotle score, patient weight, intra-operative packed red blood cell transfusion, having heart transplant procedure.In open-heart surgery, thrombocytopenia occur commonly CPB. findings show strong