Leow Esther Huimin, Chan Yoke Hwee, Ng Yong Hong, Lim Joel Kian Boon, Nakao Masakazu, Lee Jan Hau
1 Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.
2 Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore, Singapore.
World J Pediatr Congenit Heart Surg. 2018 Jan;9(1):79-90. doi: 10.1177/2150135117743211.
Children undergoing cardiac surgery are at risk of developing acute kidney injury (AKI). Preventing cardiac surgery-associated AKI (CS-AKI) is important as it is associated with increased early- and long-term mortality and morbidity. Targeting modifiable risk factors (eg, avoiding poor renal perfusion, nephrotoxic drugs, and fluid overload) reduces the risk of CS-AKI. There is currently no strong evidence for the routine use of pharmacological approaches (eg, aminophylline, dexmedetomidine, fenoldopam, and steroids) to prevent CS-AKI. There is robust evidence to support the role of early peritoneal dialysis as a nonpharmacologic approach to prevent CS-AKI.
接受心脏手术的儿童有发生急性肾损伤(AKI)的风险。预防心脏手术相关的急性肾损伤(CS-AKI)很重要,因为它与早期和长期死亡率及发病率增加有关。针对可改变的风险因素(如避免肾灌注不足、肾毒性药物和液体超负荷)可降低CS-AKI的风险。目前尚无强有力的证据支持常规使用药理学方法(如氨茶碱、右美托咪定、非诺多泮和类固醇)来预防CS-AKI。有充分的证据支持早期腹膜透析作为预防CS-AKI的非药物方法的作用。