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- Title
Low incidence of acute kidney injury in VLBW infants with restrictive use of mechanical ventilation.
- Authors
Burgmaier, Kathrin; Zeiher, Melanie; Weber, Anna; Cosgun, Zülfü C.; Aydin, Aynur; Kuehne, Benjamin; Burgmaier, Mathias; Hellmich, Martin; Mehler, Katrin; Kribs, Angela; Habbig, Sandra
- Abstract
Background: We assessed the incidence of and risk factors for acute kidney injury (AKI) in very low birthweight infants (VLBW) in a center with a specific neonatal management protocol focusing on avoidance of early mechanical ventilation (MV). Methods: This retrospective single center analysis includes 128 infants born in 2020 with a gestational age ≥ 22 weeks who were screened for AKI using the nKDIGO criteria. Results: AKI was identified in 25/128 patients (19.5%) with eight of them (6.3%) presenting with severe AKI. Low gestational age, birthweight and 10-minute Apgar score as well as high CRIB-1 score were all associated with incidence of AKI. Forty-five percent of the infants with MV developed AKI vs. 8.9% of those without MV (p < 0.001). Early onset of MV and administration of more than 3 dosages of NSAIDs for patent duct were identified as independent risk factors for AKI in a logistic regression analysis. Conclusions: We report a substantially lower frequency of AKI in VLBW infants as compared to previous studies, along with a very low rate of MV. A neonatal protocol focusing on avoidance of MV within the first days of life may be a key factor to decrease the risk of AKI in immature infants.
- Subjects
GERMANY; NEPHROTOXICOLOGY; MOTHERS; LENGTH of stay in hospitals; NEONATAL intensive care; ACADEMIC medical centers; PULMONARY surfactant; NONSTEROIDAL anti-inflammatory agents; CONTINUOUS positive airway pressure; MULTIPLE regression analysis; EVALUATION; VERY low birth weight; HOSPITAL birthing centers; RETROSPECTIVE studies; ACQUISITION of data; NEONATAL intensive care units; DISEASE incidence; GESTATIONAL age; MANN Whitney U Test; HOSPITAL care of newborn infants; RISK assessment; ARTIFICIAL respiration; MEDICAL protocols; DYSPNEA; SEVERITY of illness index; MEDICAL records; BIRTH weight; DESCRIPTIVE statistics; CAFFEINE; CHI-squared test; REGULATION of body fluids; RESEARCH funding; APGAR score; LOGISTIC regression analysis; DATA analysis software; ACUTE kidney failure; CREATININE; DISEASE risk factors; CHILDREN
- Publication
Pediatric Nephrology, 2024, Vol 39, Issue 4, p1279
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-023-06182-8