Diagnosis and correction of cardiorenal syndrome in neonatal surgery
ORIGINAL PAPERS
Abstract
Introduction.Cardiorenal syndrome (CRS) is a fairly common pathological process in children with congenital malformations (CM) who are in critical conditions. Its diagnosis is difficult. The purposeis the identification risk factors for the cardiorenal syndrome’s development in newborns with the gastrointestinal tract congenital malformations requiring surgical intervention.Materials and methods. A retrospective cohort study was conducted in the ICU “Regional Clinical Hospital” in Novosibirsk in 2021–2023. The study included 111 patients after surgery in the early neonatal period. The median patients’ age was 2 days (1; 2). Depending on the presence of cardiorenal syndrome confirmed by laboratory data (troponin T, NT-pro-BNP, blood creatinine) two groups were formed.Results.The levels of troponin T, NT-pro-BNP, blood creatinine had the high correlation. Based on the combined changes in troponin T levels — more than 0,1 ng/ml (Se 86%, Sp 83%), NT-pro-BNP more than 6000 pg/ml (Se 88%, Sp 82%) and blood creatinine (calculated per days of life according to glomerular filtration rate ≤20 ml/m2/min (Se 82%, Sp 79%) diagnostics were carried out. Newborns with cardiorenal syndrome had an increased need for albumin transfusion (p=0,042), the need for vasopressor support was statistically insignificant (p=0,060) on the 1st day after surgery. On the 3rd day, using loop diuretic for hemodynamic unloading was statistically significant in children with CRS (p = 0,029), prematurity is an independent risk factor for the development of CRS (p=0,009).Conclusion. The maximum incidence of cardiorenal syndrome is noted on the third day after surgery with regression of symptoms in most patients by the seventh day.
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