Chesney R W, Kaplan B S, Freedom R M, Haller J A, Drummond K N
J Pediatr. 1975 Sep;87(3):381-8. doi: 10.1016/s0022-3476(75)80640-8.
Acute renal failure occurred in association with cardiac surgery in 20 of 248 infants (8%). Hypotension, poor tissue perfusion, and hypoglycemia were the most important factors recognized in the pathogenesis and outcome of the ARF. However, many infants were extremely ill preoperatively. The most frequent operative procedures performed in the 20 patients were open-heart surgery with total correction under deep hypothermia and repair of coarctation of the aorta. Thirteen of the 20 infants with ARF died. The combination of a major operative procedure, cardiac failure, hypoglycemia, hypotension, and compromised renal function imposes important constraints in the treatment of hyperkalemia, hypoglycemia, correction of acid-base distrubances, and the administration of fluids.
248例婴儿中有20例（8%）在心脏手术后发生急性肾衰竭。低血压、组织灌注不良和低血糖是急性肾衰竭发病机制及预后中公认的最重要因素。然而，许多婴儿术前病情极其严重。这20例患者最常进行的手术操作是在深度低温下进行全矫正的心脏直视手术和主动脉缩窄修复术。20例发生急性肾衰竭的婴儿中有13例死亡。大型手术、心力衰竭、低血糖、低血压和肾功能受损共同给高钾血症的治疗、低血糖的处理、酸碱平衡紊乱的纠正以及液体的输注带来了重要限制。
