KALP DAMAR CERRAHİSİNE ALINAN PEDİATRİK HASTALARDA KAN TRANSFÜZYON HACMİ İLE BÖBREK YETMEZLİĞİ GELİŞİMİ ARASINDAKİ İLİŞKİNİN ARAŞTIRILMASI

Abstract

Celik Y. Investigation of the Relationship Between Blood Transfusion Volume and the Development of Kidney Failure in Pediatric Patients Undergoing Cardiovascular Surgery, Department of Anesthesiology and Reanimation, Specialization Thesis, Ankara, 2025. Cardiac surgeries performed in children are procedures that highly likely require blood transfusion. The likelihood of developing complications such as kidney failure, pneumonia, heart failure, prolonged hospital stay, and increased mechanical ventilation duration is higher due to blood transfusion. There is no effective prevention for acute kidney injury (AKI) following cardiac surgery, nor is there an effective treatment if AKI occurs. Therefore, identifying modifiable risk factors that contribute to AKI development is crucial. In this study, we aimed to examine the risk level of renal damage associated with the volume of blood transfusion, which is one of the modifiable risk factors for AKI in pediatric patients undergoing cardiac surgery. After obtaining ethical committee approval, 205 pediatric patients who underwent cardiac surgery with cardiopulmonary bypass in our hospital between January 2013 and September 2023 and met the study criteria were included. In addition to the patients' baseline demographic and clinical data, intraoperative agents used, anesthesia duration, aortic crossclamp time, pump time, blood product usage and quantity, fluid intake and output, and postoperative creatinine levels during the first two days were retrospectively analyzed. Among the included patients, 111 (55.6%) were male, and 94 (44.4%) were female. The average age of the patients was 2.78 ± 3.53 years. The incidence of postoperative AKI was found to be 34.6% (71 patients). The postoperative AKI development rate was 81.7% in patients who received erythrocyte suspension transfusion, while it was 56.7% in those who did not. It was determined that being aged between 1 month and 1 year, having a low body weight, intraoperative use of furosemide, vasopressor administration, and erythrocyte transfusion were risk factors for postoperative AKI development. Our study demonstrated that postoperative AKI significantly affects mortality. It was found that intraoperative erythrocyte suspension transfusion and the amount of transfusion increased the risk of AKI development. We believe that modifications can be made to reduce the risk of AKI following cardiopulmonary bypass. Patients can be assessed for AKI risk factors in the preoperative period, and preventive measures can be taken, while intraoperative risk factors contributing to AKI can be avoided.