The impact of one-step hybrid procedure on kidney function in tetralogy of Fallot children with major aortopulmonary collateral arteries
10.3760/cma.j.issn.1001-4497.2018.09.008
- VernacularTitle:一站式杂交手术治疗法洛四联症合并体肺侧支对术后肾功能的影响
- Author:
Tuo PAN
1
;
Xu WANG
;
Shoujun LI
;
Hao ZHANG
;
Dan LI
Author Information
1. 100037,北京协和医学院 中国医学科学院阜外医院小儿ICU
- Keywords:
Tetralogy of Fallot;
Intraoperative hybrid procedure;
Major aortopulmonary collateral arteries;
Acute kidney injury
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(9):543-547
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of one-step hybrid procedure(HP) which combined surgical and interventional approaches simultaneously on kidney function in tetralogy of Fallot(TOF) with major aortopulmonary collateral arteries (MAPCAs).Methods The children with TOF who underwent corrective procedures,whether underwent one-step HP,aged less than 3-years during the period of January 2014 to June 2015,were reviewed in this retrospective cohort study.Univariate analyse was performed to compare with traditional operation(control group) and one-step HP(HP group).Multivariable analyses was carried out to identify significant determinants of one-step HP.Results In univariate analyses,the age,preoperative oxygen saturation,Nakata indext、McGoon index、LVEDIV、CPB time、ACC time and transannular patch had no significant difference between HP group and control group.The morbidity of acute kidney injury(AKI) was 59.38％ in one-step HP group as well as 23.76％ in traditional operation group.The one-step HP could significantly increased AKI compared with control group.Multivariable logistic regression showed that younger children who had less mechanical ventilation time(OR:0.971,95 ％ CI:0.949-0.994,P =0.003),less time to negative fluid balance (OR:0.984,95 ％ CI:0.967-0.998,P =0.015) and higher morbidity of AKI(OR:4.817,95％ CI:2.597-8.937,P =0.001) in HP group.Conclusion The one-step HP could significantly decrease the mechanical ventilation time and time to negative fluid balance while it increased the morbidity of mild AKI.Moreover,the mild AKI was not associated with poor outcomes when children was prophylactically implemented renal protection.
