Auteur(s) : Devoucoux Camille
Composante : MEDECINE
Date de création : 30-06-2021

Description : Médecine (pédiatrie), Background: Although advances in neonatal care have increased the survival rate of newborns, acute renal injury (AKI) remains a leading cause of mortality and morbidity in neonatal intensive care units. Objective: The objective of our study is to assess the obstetric, perinatal and neonatal characteristics of newborns with AKI as well as to determine their risk factors for death. Method: A retrospective study was carried out with a population including 209 newborns hospitalized in the neonatology department of the Strasbourg University Hospital from 2015 to 2020. First of all, we carried out a descriptive study to assess the obstetrical characteristics, perinatal and neonatal neonates with ARI. Then we compared the newborns with surviving ARI and deceased to determine their risk factors for death. AKI was determined using the definition of neonatal modified KDIGO. Results: The mean maternal age was 30.9 years. 58% of newborns are born by cesarean section. The mean Apgar score at 1 and 5 min was 4 and 7. 66% of newborns received resuscitation at birth. The mean term was 31.1 weeks with a mean birth weight of 1.7 kg. The mean age at onset of ARI was 4 days. The most frequent etiologies of AKI in order of incidence were acute circulatory failure (30%) including shock, sepsis and ulcerative necrotizing enterocolitis, followed by anoxo-ischemic encephalopathy (24%), persistent ductus arteriosus treated with NSAIDs (21%), functional AKI in a postoperative or dehydration context (11%) and CAKUTs (10%). The death rate was 25%. In multivariate analysis, the risk factors associated with the death of newborns with AKI were resuscitation at birth (OR 12.3 [2.37-80.4] p = 0.004), treatment of arterial hypotension (OR 17.1 [4.56 -73.9] p 160 µmol / l (OR 53.7 [4.56-99.3] p = 0.003) Conclusion: Newborns with AKI are more seriously ill patients with a relatively low mean APGAR at 1 and 5 min, a high resuscitation rate at birth, a need for ventilation and a high mortality rate. Risk factors associated with death are resuscitation at birth, treatment of low blood pressure and a maximum creatinine value- 160 µmol
Mots-clés libres : Insuffisance rénale aiguë -- Chez l'enfant, 618.92, Encéphalopathies, Entérocolite nécrosante du nouveau-né, Complications infectieuses de la grossesse -- Dissertation universitaire, 618.92
Couverture : FR