Lack of Furosemide Responsiveness Predicts Acute Kidney Injury in Infants After Cardiac Surgery

The Annals of Thoracic Surgery
Aadil KakajiwalaJoshua J Blinder

Abstract

This was a retrospective study to determine whether lack of furosemide responsiveness (LFR) predicts acute kidney injury (AKI) after cardiopulmonary bypass surgery in infants. Infants (less than 1 year of age) undergoing cardiopulmonary bypass surgery, receiving routine postoperative furosemide (0.8 to 1.2 mg/kg per dose between 8 and 24 hours after surgery) were included. Urine output was measured 2 and 6 hours after furosemide dose. Lack of furosemide responsiveness was defined a priori as urine output less than 1 mL · kg(-1) · h(-1) after furosemide. Serum creatinine was corrected for fluid balance. Acute kidney injury was determined using changes in uncorrected and corrected serum creatinine. The predictive utility of LFR was assessed using receiver-operating characteristics curve analysis. We analyzed 568 infants who underwent cardiopulmonary bypass. Eighty-one (14.3%) had AKI using uncorrected serum creatinine; AKI occurred in 41 (7.2%) after correcting for fluid overload. Patients with AKI had a lower response to furosemide (median urine output 2 hours: 1.2 versus 3.4 mL · kg(-1) · h(-1), p = 0.01; median urine output 6 hours: 1.3 versus 2.9 mL · kg(-1) · h(-1), p = 0.01). After creatinine correction, LFR predicts AKI de...Continue Reading

Citations

Aug 24, 2018·Anesthesia and Analgesia·Alexander ZarbockJohn A Kellum
Nov 15, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jay L KoynerClaudio Ronco
May 10, 2020·Critical Care : the Official Journal of the Critical Care Forum·Jia-Jin ChenGeorge Kuo
Dec 8, 2020·Current Treatment Options in Pediatrics·Michael A CarlisleKatja M Gist
Feb 18, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Michelle C Starr, Shina Menon
Mar 3, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Dominic ZanaboniJoshua J Blinder
Mar 19, 2021·Pediatric Research·Rupesh RainaTimothy Bunchman
May 12, 2021·Renal Failure·Blaithin A McMahon, Lakhmir S Chawla
Feb 13, 2019·The Journal of Thoracic and Cardiovascular Surgery·Jamie PenkRajit K Basu
Oct 3, 2021·Pediatrics·Michelle C StarrUNKNOWN Neonatal Kidney Collaborative Board

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