Niezen Cornelia K, Modestini Marco, Massari Dario, Bos Arend F, Scheeren Thomas W L, Struys Michel M R F, Vos Jaap Jan
Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Anesthesiology, Isala Hospital, Zwolle, The Netherlands.
Semin Cardiothorac Vasc Anesth. 2025 Sep;29(3):209-218. doi: 10.1177/10892532251316682. Epub 2025 Feb 10.
IntroductionPostoperative acute kidney injury (AKI) is a common postoperative complication in cardiac surgery, with varying reported incidences and prognostic factors. Renal hypoperfusion is believed to be a key factor contributing to postoperative AKI. Near-infrared spectroscopy (NIRS) monitoring, which assesses regional tissue saturation (RSO), has been suggested as a tool to predict postoperative AKI. The aim of this systematic review was to examine the prognostic value of perioperative NIRS monitoring in predicting postoperative AKI in pediatric patients.Methods and ResultsAfter a systematic search in PubMed, EMBASE, and Cochrane library, twenty studies (1517 patients) were included. The inter-rater agreement on study quality was strong, yet a high risk of bias was identified.ConclusionThe heterogeneity of the results-in part attributable to several potential confounding factors regarding study population, monitoring technique and the definition of AKI-together with the lack of a clear and consistent association between RSO values and AKI, currently preclude recommending NIRS monitoring as a reliable and valid clinical tool to "predict" AKI in the individual patient.
引言
术后急性肾损伤（AKI）是心脏手术常见的术后并发症，其报道的发病率和预后因素各不相同。肾灌注不足被认为是导致术后AKI的关键因素。近红外光谱（NIRS）监测可评估局部组织饱和度（RSO），已被提议作为预测术后AKI的一种工具。本系统评价的目的是探讨围手术期NIRS监测对预测儿科患者术后AKI的预后价值。
方法与结果
在对PubMed、EMBASE和Cochrane图书馆进行系统检索后，纳入了20项研究（1517例患者）。研究质量的评分者间一致性较强，但发现存在较高的偏倚风险。
结论
结果的异质性——部分归因于研究人群、监测技术和AKI定义等几个潜在的混杂因素——以及RSO值与AKI之间缺乏明确一致的关联，目前不建议将NIRS监测作为一种可靠有效的临床工具来“预测”个体患者的AKI。
