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复发性急性肾损伤与先天性心脏病婴儿的语言发育延迟有关。

Recurrent acute kidney injury is associated with delayed language development in infants with Congenital Heart Disease.

作者信息

Pande Chetna K, Akcan-Arikan Ayse, Monteiro Sonia, Guffey Danielle, Serrano Faridis, Afonso Natasha, Puri Kriti, Achuff Barbara-Jo, Shekerdemian Lara, Noll Lisa

机构信息

Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Division of Nephrology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

出版信息

Cardiol Young. 2024 Nov;34(11):2377-2381. doi: 10.1017/S1047951124025873. Epub 2024 Oct 10.

Abstract

OBJECTIVE

Neurodevelopmental delay is common in children who undergo surgery for Congenital Heart Disease (CHD) in infancy. Cardiac surgery associated acute kidney injury (CS-AKI) occurs frequently in the paediatric cardiac Intensive care unit (ICU). Cardiac surgery associated acute kidney injury (CS-AKI) is associated with worse neurodevelopmental scores and delay in cognitive, language, and motor domains in children with CHD. No known data exist regarding the association of CS-AKI and motor and language subscales. In this study, we explored the relationship between CS-AKI and receptive and expressive language, as well as gross and fine motor delay.

METHODS

This was a single centre retrospective observational cohort study. Children who underwent surgery for CHD and developed recurrent CS-AKI in the first year of life who had follow-up neurodevelopmental testing using the Bayley Scale of Infant Development Version III were included. Neurodevelopmental delay subscales assessed included: receptive and expressive language, fine and motor skills.

RESULTS

The study cohort included 203 children. Recurrent CS-AKI was significantly associated with lower scores in receptive and expressive language, as well as fine and gross motor on unadjusted analyses. On adjusted analyses, recurrent CS-AKI was significantly associated with severe receptive language delay.

CONCLUSION

The independent association of recurrent CS-AKI with severe language delay in children who undergo surgery for CHD in infancy is novel. Our findings may contribute to the understanding of language impairment in this population. Further studies are required to better understand this relationship and any potentially modifiable factors.

摘要

目的

神经发育迟缓在婴儿期接受先天性心脏病(CHD)手术的儿童中很常见。心脏手术相关急性肾损伤(CS-AKI)在小儿心脏重症监护病房(ICU)中频繁发生。心脏手术相关急性肾损伤(CS-AKI)与CHD患儿较差的神经发育评分以及认知、语言和运动领域的延迟有关。关于CS-AKI与运动和语言子量表之间的关联尚无已知数据。在本研究中,我们探讨了CS-AKI与接受性和表达性语言以及粗大和精细运动延迟之间的关系。

方法

这是一项单中心回顾性观察队列研究。纳入了在生命的第一年接受CHD手术并发生复发性CS-AKI且使用贝利婴儿发育量表第三版进行了随访神经发育测试的儿童。评估的神经发育延迟子量表包括:接受性和表达性语言、精细和运动技能。

结果

研究队列包括203名儿童。在未调整的分析中,复发性CS-AKI与接受性和表达性语言得分较低以及精细和粗大运动得分较低显著相关。在调整分析中,复发性CS-AKI与严重的接受性语言延迟显著相关。

结论

复发性CS-AKI与婴儿期接受CHD手术的儿童严重语言延迟之间的独立关联是新颖的。我们的发现可能有助于理解这一人群的语言障碍。需要进一步研究以更好地理解这种关系以及任何潜在的可改变因素。

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