The Role of Dexmedetomidine in Decreasing Acute Kidney Injury in Children with Acyanotic Heart Disease Undergoing Total Correction by A New Urinary Biomarker Kidney Injury Molecule-1
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- Category: Vol. 84, March 2016
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The Role of Dexmedetomidine in Decreasing Acute Kidney Injury in Children with Acyanotic Heart Disease Undergoing Total Correction by A New Urinary Biomarker Kidney Injury Molecule-1, SARA A. KASEM, AHMED M. EL-HADDAD, AZZA M. EZZAT, WAFAA M. EL-SADEK, AHMED LOTFY, AHMED HASANIN, AMIRA EL-KHATTEB and OLFAT G. SHAKER
Abstract
Background: Dexmedetomidine is an alpha 2 agonist with sedative properties. Some studies suggested that it has an organ protective effect. In this randomized controlled trial, we tested the protective effect of dexmedetomidine on the kidney in pediatric cardiac population.
Patients and Methods: Seventy two children with acyanotic heart disease were randomized into two groups, Group D (dexmedetomidine group) and Group C (control group) patients received an initial bolus dose of dexmedetomidine (0.5mcg/kg) over 10min in Group D and saline in Group C, followed by a continuous infusion of 0.5mcg/kg/h. Serum creatinine and KIM-1 were measured preoperatively and 24 hours postoper-atively to diagnose AKI.
Results: Preoperative serume creatinine in Group D was (0.4±0.2) and (0.4±0.3) in Group C p=(0.1) while postoperative serum creatinine was (0.5±0.3) in Group D and (0.50.2) in Group C, p=(0.6). At twenty four hour KIM-1 (612.21±683.80) pg/ml in Group D and (576.89±686.78) pg/ml in Group C p= (0.8). In patients with prolonged bypass time >90 minutes, the level of KIM-1 was (666.8±734.15) in Group D and (986.7 ±691.13) in Group C (p=0.03).
Conclusion: Dexmedetomidine showed a protective effect on the kidney in children underwent prolonged cardiopulmo-nary bypass (>90min) assessed by KIM-1 at 24 hours post-bypass.