Acute Kidney Injury and Renal Regional Oxygen Saturation During Aortic Arch Reconstruction in Infants

Abstract

Acute kidney injury is a serious postoperative complication following cardiac surgery. The aortic arch repair technique using antegrade selective cerebral perfusion has been used, but it is unclear whether subdiaphragmatic organs such as the kidneys are perfused adequately. The authors compared intraoperative renal regional oxygen saturation using near-infrared spectroscopy between infants with and without postoperative acute kidney injury after undergoing aortic arch reconstruction. Retrospective medical records review. University medical center. Elective cardiac surgical infants. The author reviewed the perioperative clinical records of infants who underwent aortic arch reconstruction surgery using antegrade selective cerebral perfusion. During the operation, prestenotic (right radial or right brachial artery) and poststenotic (femoral or umbilical artery) invasive arterial blood pressure and cerebral and renal regional oxygen saturation were monitored continuously. Development of acute kidney injury within 72 hours of surgery was investigated. A total of 47 patients were enrolled in this study. Postoperative acute kidney injury occurred in 19 patients (40.4%). Intraoperative renal regional oxygen saturation was similar between patients with and without acute kidney injury. Intraoperative prestenotic and poststenotic mean arterial blood pressure and cerebral regional oxygen saturation also were similar between the 2 groups. The intraoperative renal tissue oxygen saturation was not different between the groups with or without postoperative acute kidney injury in infants who underwent aortic arch repair using antegrade selective cerebral perfusion.