• Luke W Schroeder, Jason R Buckley, Robert E Stroud, Renee H Martin, Elizabeth K Nadeau, Ryan Barrs, and Eric M Graham.
• Division of Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
• Pediatr Crit Care Me. 2019 Oct 1; 20 (10): 957-962.

ObjectivesAcute kidney injury is a frequent complication following neonatal cardiac surgery and is associated with significant morbidity and mortality. The objectives of this study were to determine if plasma neutrophil gelatinase-associated lipocalin levels were associated with acute kidney injury and clinical outcomes in neonates with congenital heart disease undergoing cardiopulmonary bypass.DesignRetrospective single-center observational study.SettingA pediatric cardiac ICU within a tertiary-care academic hospital.PatientsPatients age less than 30 days undergoing cardiac surgery requiring cardiopulmonary bypass.InterventionsNone.Measurements And Main ResultsPlasma neutrophil gelatinase-associated lipocalin peaked at 12 hours postcardiopulmonary bypass and more than doubled compared with preoperative levels. Higher preoperative and 24-hour postoperative neutrophil gelatinase-associated lipocalin levels were associated with acute kidney injury (r = 0.30, r = 0.49), longer duration of mechanical ventilation (r = 0.40, r = 0.51), ICU (r = 0.32, r = 0.33) and hospital lengths of stay (r = 0.28, r = 0.32), and total hospital charges (r = 0.35, r = 0.30; all p values < 0.05).ConclusionsBoth preoperative and 24-hour postoperative plasma neutrophil gelatinase-associated lipocalin levels are associated with acute kidney injury and worse clinical outcomes in neonates undergoing cardiac surgery. Plasma neutrophil gelatinase-associated lipocalin levels may have a role in risk stratification for predicting postoperative renal dysfunction as well as providing a potential clinical trajectory in the postoperative period.

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