high-dose fenoldopam reduces postoperative neutrophil gelatinase-associated lipocaline and cystatin c levels in pediatric cardiac surgery高剂量fenoldopam减少术后中性粒细胞gelatinase-associated lipocaline和半胱氨酸蛋白酶抑制物c水平在小儿心脏手术.pdfVIP

Ricci et al. Critical Care 2011, 15:R160 /content/15/3/R160 RESEARCH Open Access High-dose fenoldopam reduces postoperative neutrophil gelatinase-associated lipocaline and cystatin C levels in pediatric cardiac surgery 1* 2 1 1 2 1 Zaccaria Ricci , Rosa Luciano , Isabella Favia , Cristiana Garisto , Maurizio Muraca , Stefano Morelli , Luca Di Chiara1, Paola Cogo1 and Sergio Picardo3 Abstract Introduction: The aim of the study was to evaluate the effects of high-dose fenoldopam, a selective dopamine-1 receptor, on renal function and organ perfusion during cardiopulmonary bypass (CPB) in infants with congenital heart disease (CHD). Methods: A prospective single-center randomized double-blind controlled trial was conducted in a pediatric cardiac surgery department. We randomized infants younger than 1 year with CHD and biventricular anatomy (with exclusion of isolated ventricular and atrial septal defect) to receive blindly a continuous infusion of fenoldopam at 1 μg/kg/min or placebo during CPB. Perioperative urinary and plasma levels of neutrophil gelatinase-associated lipocaline (NGAL), cystatin C (CysC), and creatinine were measured to assess renal injury after CPB. Results: We enrolled 80 patients: 40 received fenoldopam (group F) during CPB, and 40 received placebo (group P). A significant increase of urinary NGAL and CysC levels from baseline to intensive care unit (ICU) admission followed by restoration of normal values after 12 hours was observed in both groups. However, urinary NGAL and CysC values were significantly reduced at the end of surgery and 12 hours after ICU admission (uNGAL only) in group F compared with group P (P = 0.025 and 0.039, respectively). Plasma NGAL and Cy