TY - JOUR
T1 - Prognostic Value of Perioperative Near-Infrared Spectroscopy Monitoring for Postoperative Acute Kidney Injury in Pediatric Cardiac Surgery
T2 - A Systematic Review
AU - Niezen, Cornelia K.
AU - Modestini, Marco
AU - Massari, Dario
AU - Bos, Arend F.
AU - Scheeren, Thomas W.L.
AU - Struys, Michel M.R.F.
AU - Vos, Jaap Jan
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/2/10
Y1 - 2025/2/10
N2 - Introduction: Postoperative acute kidney injury (AKI) is a common postoperative complication in cardiac surgery, with varying reported incidences and prognostic factors. Renal hypoperfusion is believed to be a key factor contributing to postoperative AKI. Near-infrared spectroscopy (NIRS) monitoring, which assesses regional tissue saturation (RSO2), has been suggested as a tool to predict postoperative AKI. The aim of this systematic review was to examine the prognostic value of perioperative NIRS monitoring in predicting postoperative AKI in pediatric patients.Methods and Results: After a systematic search in PubMed, EMBASE, and Cochrane library, twenty studies (1517 patients) were included. The inter-rater agreement on study quality was strong, yet a high risk of bias was identified.Conclusion: The heterogeneity of the results—in part attributable to several potential confounding factors regarding study population, monitoring technique and the definition of AKI—together with the lack of a clear and consistent association between RSO2 values and AKI, currently preclude recommending NIRS monitoring as a reliable and valid clinical tool to “predict” AKI in the individual patient.
AB - Introduction: Postoperative acute kidney injury (AKI) is a common postoperative complication in cardiac surgery, with varying reported incidences and prognostic factors. Renal hypoperfusion is believed to be a key factor contributing to postoperative AKI. Near-infrared spectroscopy (NIRS) monitoring, which assesses regional tissue saturation (RSO2), has been suggested as a tool to predict postoperative AKI. The aim of this systematic review was to examine the prognostic value of perioperative NIRS monitoring in predicting postoperative AKI in pediatric patients.Methods and Results: After a systematic search in PubMed, EMBASE, and Cochrane library, twenty studies (1517 patients) were included. The inter-rater agreement on study quality was strong, yet a high risk of bias was identified.Conclusion: The heterogeneity of the results—in part attributable to several potential confounding factors regarding study population, monitoring technique and the definition of AKI—together with the lack of a clear and consistent association between RSO2 values and AKI, currently preclude recommending NIRS monitoring as a reliable and valid clinical tool to “predict” AKI in the individual patient.
KW - AKI
KW - cardiac anesthesia
KW - cardiac surgery
KW - cerebral oximetry
KW - children
KW - congenital heart disease
KW - near infrared spectroscopy
KW - near-infrared spectroscopy
KW - NIRS
KW - pediatric intensive care
UR - http://www.scopus.com/inward/record.url?scp=85217864000&partnerID=8YFLogxK
U2 - 10.1177/10892532251316682
DO - 10.1177/10892532251316682
M3 - Review article
C2 - 39928846
SN - 1089-2532
JO - Seminars in Cardiothoracic and Vascular Anesthesia
JF - Seminars in Cardiothoracic and Vascular Anesthesia
ER -