Abstract

CABAS, Lilian et al. Disfunción renal en postoperatorio de cirugía cardíaca pediátrica con circulación extracorpórea . Rev. colomb. anestesiol. [online]. 2005, vol.33, n.2, pp.85-91. ISSN 0120-3347.

Background: Postoperative renal dysfunction is associated to poor prognosis. The influence of perioperative factors in the development of renal disorder in children is not clearly understood. The aim of the study was to determine the incidence of renal dysfunction, the main risk factors and the association with mortality and hospital stay. Methods: We studied prospectively 236 patients, under 12 years old. We excluded patients who died in the first 24 hours after cardiac surgery and the ones scheduled only for atrial septal defect closure. Patients who developed renal dysfunction were the ones with abnormal values for creatinine clearance, with an increase of 25% the basal preoperative creatinine value or oliguria. The association between renal dysfunction and perioperative variables was studied by univariate and multivariate analysis. Results: Of the 236 patients, 72% developed renal dysfunction, 4.2% had renal failure that required dialysis. The mortality rate of patients with renal dysfunction was 9.9% compared with 80 % in patients with renal failure. The only variable that had independent association with renal dysfunction was postoperative hematocrit. (p= 0.001). Conclusion: There is an independent association between renal dysfunction and perioperative mortality in pediatric cardiac surgery with cardiopulmonary bypass, as well as with the increment in hospital and ICU stay.

Keywords : Cardiac surgical procedure; extracorporeal circulation; renal failure.

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