Acetaminophen protective against AKI after pediatric cardiac surgery

  • Van Driest SL & al.
  • JAMA Pediatr
  • 14 May 2018

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • Postoperative acetaminophen may reduce the risk for acute kidney injury (AKI) in pediatric patients who undergo cardiac surgery.

Why this matters

  • "Further analysis to validate these findings, potentially through a prospective, randomized trial, may establish acetaminophen as a preventive agent for AKI," say researchers.

Key results

  • Unadjusted analyses showed that children with postoperative AKI had lower median acetaminophen doses than those without AKI (47 vs 78 mg/kg; P<.001>
  • Researchers found acetaminophen was protective against postoperative AKI after adjusting for age, cardiopulmonary bypass time, red blood cell distribution width, postoperative hypotension, nephrotoxin exposure, and Risk Adjustment for Congenital Heart Surgery score (OR, 0.86 per each additional 10 mg/kg).

Study design

  • Researchers studied children admitted for cardiac surgery (n=999; age >28 days), administering acetaminophen to them within 48 postoperative hours.
  • The main outcome was AKI within the first postoperative week.
  • Funding: National Institutes of Health.

Limitations

  • The study was retrospective and observational.

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