Articles: operative.
-
Critical care medicine · Oct 2021
Multicenter StudyEpidemiology of Acute Kidney Injury After Neonatal Cardiac Surgery: A Report From the Multicenter Neonatal and Pediatric Heart and Renal Outcomes Network.
Cardiac surgery-associated acute kidney injury occurs commonly following congenital heart surgery and is associated with adverse outcomes. This study represents the first multicenter study of neonatal cardiac surgery-associated acute kidney injury. We aimed to describe the epidemiology, including perioperative predictors and associated outcomes of this important complication. ⋯ Cardiac surgery-associated acute kidney injury occurs frequently after neonatal cardiac surgery in both cardiopulmonary bypass and noncardiopulmonary bypass patients. Rates vary significantly across hospitals. Only stage 3 cardiac surgery-associated acute kidney injury is associated with mortality. Cardiac surgery-associated acute kidney injury was not associated with any other outcomes. Kidney Disease Improving Global Outcomes criteria may not precisely define a clinically meaningful renal injury phenotype in this population.
-
Anesthetic management of pediatric circumcisions typically involves intravenous access and advanced airway management. We explored the use of a minimally invasive anesthetic protocol for pediatric circumcisions akin to the anesthetic management for bilateral myringotomy and tympanostomy. ⋯ The mean (standard deviation) intraoperative anesthesia time was 41.4 (5.7) minutes, and 1 patient experienced a mild intraoperative complication with emesis at induction. Pediatric circumcisions can be efficiently and safely performed with minimally invasive anesthesia.