Abstract
Objective. To improve the results of cardiac surgery in newborns and young children by identifying the most significant risk factors
for the development of acute kidney damage (AKI), as well as the development and implementation of an algorithm for its prevention
in the postoperative period.
Material and methods. The study is based on the results of treatment of 245 children with congenital heart disease (CHD) in the
Perinatal Center of the St. Petersburg State Pediatric Medical University from 2014 to 2017. All patients were divided into two groups.
The first group included patients operated in the period from September 2014 to December 2015; the second group included
patients operated from January 2016 to October 2017, which corresponded to the use in the clinic of a set of measures for the prevention
of AKI.
Results. It was found that the incidence of AKI in the second group is significantly lower than in the first group (62.5% and 34%,
respectively). Risk factors for the development of AKI after surgical correction of congenital heart defects were identified. An effective
model for predicting of likelihood of developing AKI in the perioperative period was developed.
Conclusion. The proposed model can predict development of AKI in the postoperative period with 85.9% accuracy. The sensitivity
of the model is 77.4%, specificity – 92%. The proposed measures for the prevention of AKI can significantly reduce the incidence of
AKI in children with CHD after cardiac surgery.
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About the authors
- Aleksey B. Naumov, Cand. Med. Sc., Associate Professor, orcid.org/0000-0003-0323-0162;
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Anastasiya A. Seliverstova, Cardiologist, Ultrasonic Diagnostics Physician, orcid.org/0000-0003-2992-2255;
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Sergey P. Marchenko, Dr Med. Sc., Professor, orcid.org/0000-0003-4785-4532;
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Gennadiy G. Khubulava, Dr Med. Sc., Academician of Russian Academy of Sciences,
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Chief of Chair, orcid.org/0000-0001-8873-7071;
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Ol’ga Yu. Tereshenko, Anesthesiologist-Intensivist, orcid.org/0000-0003-4629-1061;
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Oksana V. Nevmerzhitskaya, Cand. Med. Sc., Deputy Chief Physician, orcid.org/0000-0002-3993-6899;
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Evgeniy S. Kulemin, Cardiovascular Surgeon, Head of Operating Unit, orcid.org/0000-0001-9208-2290;
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Mikhail S. Andreev, Senior Laboratory Assistant, orcid.org/0000-0002-4700-0265
