Predictive Value of Bedside Ultrasound Evaluation of Venous Excess Ultrasound Grading System for Acute Kidney Injury in Children Undergoing Cardiac Surgery.

IF 0.9 4区 医学 Q3 SURGERY
Weite Cao, Ruqian Wang, Ling Wang, Hong Luo
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Abstract

Aim: This study aims to investigate the predictive value of bedside ultrasound evaluation of venous excess ultrasound grading system (VExUS) for acute kidney injury (AKI) in children after cardiac surgery.

Methods: This retrospective study included 122 pediatric patients who underwent cardiac surgery at the West China Second University Hospital of Sichuan University between January 2024 and November 2024. Based on the occurrence of AKI, patients were divided into the AKI (n = 42) and non-AKI (n = 80) groups. Univariate and binary logistics regression analyses were performed to identify factors influencing AKI. The predictive value of the VExUS grading system for AKI in children after pediatric cardiac surgery was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: There were no statistically significant differences (p > 0.05) between the two groups regarding age, gender, Body Mass Index (BMI), length of hospital stay, intraoperative blood loss, postoperative hypotension, 24-hour postoperative urine output, aortic cross-clamp time, preoperative left ventricular ejection fraction, postoperative inadequate circulating blood volume, and preoperative use of positive inotropic drugs, operation time, plasma input, congenital heart disease, radical operation, and emergency surgery. However, statistically significant differences were found in postoperative blood glucose levels, VExUS scores, cardiopulmonary bypass duration, and cyanosis (p < 0.05). Binary logistics regression analysis revealed that blood glucose levels, VExUS, and cyanosis were significant factors influencing AKI after pediatric cardiac surgery (p < 0.05). ROC analysis showed that the area under the curve (AUC) of 0.803 for VExUS, with a standard error of 0.043 (95% confidence interval (CI): 0.719-0.887), a Youden index of 0.48, sensitivity of 76.25%, and specificity of 71.43%.

Conclusions: The VExUS grading system demonstrates significant clinical utility in predicting AKI in children undergoing cardiac surgery.

床边超声评价静脉过量超声分级系统对儿童心脏手术急性肾损伤的预测价值。
目的:探讨床边超声评价静脉过量超声分级系统(VExUS)对儿童心脏手术后急性肾损伤(AKI)的预测价值。方法:本回顾性研究纳入了2024年1月至2024年11月在四川大学华西第二大学医院接受心脏手术的122例儿科患者。根据AKI的发生情况,将患者分为AKI组(n = 42)和非AKI组(n = 80)。单因素和二元logistic回归分析确定影响AKI的因素。采用受试者工作特征(ROC)曲线分析评价VExUS分级系统对小儿心脏手术后AKI的预测价值。结果:两组患者在年龄、性别、体重指数(BMI)、住院时间、术中出血量、术后低血压、术后24小时尿量、主动脉交叉钳夹时间、术前左室射血分数、术后循环血容量不足、术前使用正性肌力药物、手术时间、血浆输入、先天性心脏病、根治手术、还有紧急手术。然而,术后血糖水平、VExUS评分、体外循环持续时间和发绀差异有统计学意义(p < 0.05)。二元logistic回归分析显示,血糖水平、VExUS、发绀是影响小儿心脏手术后AKI的显著因素(p < 0.05)。ROC分析显示,VExUS的曲线下面积(AUC)为0.803,标准误差为0.043(95%可信区间(CI)为0.719 ~ 0.887),约登指数为0.48,敏感性为76.25%,特异性为71.43%。结论:VExUS分级系统在预测接受心脏手术的儿童AKI方面具有重要的临床应用价值。
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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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