Low incidence of acute kidney injury in VLBW infants with restrictive use of mechanical ventilation
- Resource Type
- Original Paper
- Authors
- Burgmaier, Kathrin; Zeiher, Melanie; Weber, Anna; Cosgun, Zülfü C.; Aydin, Aynur; Kuehne, Benjamin; Burgmaier, Mathias; Hellmich, Martin; Mehler, Katrin; Kribs, Angela; Habbig, Sandra
- Source
- Pediatric Nephrology: Journal of the International Pediatric Nephrology Association. 39(4):1279-1288
- Subject
- AKI
Preterm infant
NSAID
Nephrotoxic medication
Less-invasive surfactant administration
- Language
- English
- ISSN
- 0931-041X
1432-198X
Background: We assessed the incidence of and risk factors for acute kidney injury (AKI) in very low birthweight infants (VLBW) in a center with a specific neonatal management protocol focusing on avoidance of early mechanical ventilation (MV).Methods: This retrospective single center analysis includes 128 infants born in 2020 with a gestational age ≥ 22 weeks who were screened for AKI using the nKDIGO criteria.Results: AKI was identified in 25/128 patients (19.5%) with eight of them (6.3%) presenting with severe AKI. Low gestational age, birthweight and 10-minute Apgar score as well as high CRIB-1 score were all associated with incidence of AKI. Forty-five percent of the infants with MV developed AKI vs. 8.9% of those without MV (p < 0.001). Early onset of MV and administration of more than 3 dosages of NSAIDs for patent duct were identified as independent risk factors for AKI in a logistic regression analysis.Conclusions: We report a substantially lower frequency of AKI in VLBW infants as compared to previous studies, along with a very low rate of MV. A neonatal protocol focusing on avoidance of MV within the first days of life may be a key factor to decrease the risk of AKI in immature infants.Graphical abstract: