Abstract:
AIM To explore the renal protective effects of dexmedetomidine after pediatric heart surgery.
METHODS A total of 30 pediatric patients (1-6 years) with atrial or ventricular septal defect repair were randomly assigned to receive either continuous infusion of normal saline (control group, n = 15) or dexmedetomidine (a bolus dose of 0.5 mg/kg and then an infusion of 0.5 mg/kg/h) (treatment group, n = 15) from anesthesia induction to the end of cardiopulmonary bypass. Serum creatinine (SCr) was measured before surgery (T0), 10 minutes after anesthesia induction (T1), 5 minutes after cardiopulmonary bypass weaning (T2), 2 hours after T2 (T3), and after postoperative day 1 (POD1) and postoperative day 2 (POD2) and estimated glomerular filtration rates (eGFRs) were calculated. Renal biomarkers were measured at T1, T2, and T3. Acute kidney injury (AKI) was de.ned as an absolute increase in SCr of ≥ 0.3 mg/dL or a percent increase in SCr of ≥50%.
RESULTS The incidence of AKI during the perioperative period was significantly higher in the control group than in the treatment group (P < 0.05). eGFR was significantly lower in the control group than in the treatment group at T2 and T3 (P < 0.05).
CONCLUSION Intraoperative infusion of dexmedetomidine may reduce the incidence of AKI and suppress post-bypass eGFR decline.