207 High-Dose Fenoldopam Reduces Post Operative Ngal and Cystatin C Levels During Pediatric Cardiac Surgery

Abstract

A total of 60 patients less than 1 year old were enrolled in this study: 30 received fenoldopam (group F) during CPB at the dose of 1 mcg/kg/min and 30 received placebo (group P). Differences in urine output, creatinine levels, baseline biomarkers levels, fluid balance and hemodynamic parameters were not present. Serum and urinary levels of neutrophil gelatinase associated lipocalin (sNGAL and uNGAL) and and cystatin-C (sCYS-C and uCYS-C) levels at the end of surgery (t1) and 12 hours after (t2) in group F vs group P were: sNGAL t1 88±37 ng/ml vs 107±42 ng/ml, sNGAL t2 88±44 ng/ml vs 107±42 ng/ml, uNGAL t1 22±29 ng/ml vs 60±71 ng/ml, uNGAL t2 15±13 ng/ml vs 34±59 ng/ml, sCYS-C t1 0.92±0.3 mg/l vs 1.06±0.2 mg/l, sCYS-C t2 1.126±0.3 mg/l vs 1.38±0.35 mg/l, uCYS-C t1 0.01±0.1 mg/l vs 0.196±0.34 mg/l, uCYS-C t2 0.05±0.005 mg/l vs 0.075±0.05 mg/l (always, p< 0.05). Systemic vascular resistances were 309±102 dyne*sec/cm−5 in group F vs 421±164 dyne*sec/cm−5 in group P (p=0.02). Oxygen delivery (DO2) in group F was 2474±878 ml O2/min vs 1818±797 ml O2/min in group P (p=0.02). Finally, a significant reduction in furosemide boluses (1 mg/kg) was observed in group F (OR 0.3, CI 95% 0.1-0.9, p: 0.03).Conclusions: The treatment with high-dose fenoldopam during CPB in pediatric patients undergoing cardiac surgery for CHD significantly decreased serum and urinary levels of NGAL and CYS-C, optimized diuretics administration and improved perfusion during CPB.