ĐÁNH GIÁ SUY THẬN CẤP SAU PHẪU THUẬT TIM BẨM SINH TÍM Ở TRẺ EM

Abstract

Introduction: Acute kidney injury (AKI) following surgery for cyanotic congenital heart disease (CCHD) in children is a common complication associated with high mortality, especially after the use of cardiopulmonary bypass (CPB). These patients are at increased risk of AKI due to chronic hypoxemia, polycythemia, and reduced renal arterial blood flow. Subjects and Methods: A retrospective study was conducted from July 2025 to October 2025 on pediatric patients diagnosed with CCHD who underwent surgery at Chợ Rẫy Hospital. AKI was diagnosed according to the RIFLE criteria based on postoperative serum creatinine elevation within the first 48 hours. Clinical data including diagnosis, weight, CPB duration, aortic cross-clamping time, and preoperative SpO₂ levels were collected and analyzed. Results: A total of 14 children with CCHD were included. The incidence of AKI was 63.4%. The risk and injury stages accounted for 100% of cases within the first 24 hours, while 21.4% of cases reached the failure stage within 24 to 48 hours. Prolonged CPB time was identified as a significant risk factor for AKI. Conclusion: Cyanotic congenital heart disease is a risk factor for developing AKI after cardiac surgery in children. Early detection using the RIFLE criteria may help improve postoperative care. Implementing strategies to reduce CPB duration and maintain hemodynamic stability during surgery could potentially reduce AKI risk.