Conclusion
DMED can reduce the risk of AKI in children undergoing CHS with CPB, which may be because DMED can inhibit TLR3/NF-κB signaling and its downstream inflammatory mediators.
Methods
The children undergoing CHS with CPB were randomized to the control and the DMED groups. The children in the DMED group were injected with DMED (1 µg/kg) followed by DMED infusion (0.5 µg/kg/h) until 12 h after operation; the controls received normal saline. Markers were detected before operation (T0), 30 min after anesthesia induction (T1), and at 24 h, 48 h, and 72 h after operation (T2, T3, T4).
Objective
To investigate the effect of dexmedetomidine (DMED) on acute kidney injury in children undergoing congenital heart surgery (CHS) with cardiopulmonary bypass (CPB).
Results
The heart rate and mean arterial pressure in the DMED group decreased at T1 and differed from controls at T1-T3 (all P<0.05). No intergroup differences were observed in the central venous pressure and caspase-3 level (all P>0.05). The DMED group had higher central venous pressure at T3 than at T0 (P<0.05). At T2-T4, the DMED group had lower percentages of TLR3+ cells than the controls (all P<0.05). In the DMED group, the percentagesof TLR3+ cells decreased with time; whereas in the control group, the percentage increased with time (all P<0.05). Compared with the controls, the DMED group had lower levels of NF-κB and TLR3 at T2-T4, lower levels of sCr, IL-1β, and TNF-α at T3-T4, and lower incidence of AKI at T3 (all P≤0.01).