Abstract
Background
Previous studies in non-critically ill hospitalized pediatric patients have shown that daily serum creatinine monitoring for the development of nephrotoxic medication–associated acute kidney injury decreases both the rate of high nephrotoxic medication exposure and associated acute kidney injury. Attempts to spread this successful screening program have been met with concerns that daily serum creatinine monitoring in critically ill neonates with high-risk nephrotoxic medication exposure would lead to iatrogenic anemia and an increase in blood transfusion requirements.
Methods
We measured blood transfusion rates while implementing a system of daily serum creatinine monitoring in critically ill neonates at risk for high nephrotoxic medication–associated acute kidney injury.
Results
There was no correlation between blood transfusion rates and serum creatinine monitoring rates.
Conclusions
We recommend that critically ill neonates identified as having high-risk nephrotoxic medication exposure undergo daily screening for the development of nephrotoxic medication–associated acute kidney injury.
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Conceptualization: Hailey Gavigan, Cara Slagle, Brenda Poindexter, David Hooper, and Stuart Goldstein
Methodology: Hailey Gavigan, Kelli Krallman, David Hooper, and Stuart Goldstein
Formal analysis and investigation: Hailey Gavigan, Cara Slagle, Kelli Krallman, Brenda Poindexter, David Hooper, and Stuart Goldstein
Writing—original draft preparation: Hailey Gavigan
Writing—review and editing: Cara Slagle, Kelli Krallman, Brenda Poindexter, David Hooper, and Stuart Goldstein
Supervision: Brenda Poindexter, David Hooper, and Stuart Goldstein
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Cincinnati Children’s Hospital Medical Center and Dr. Stuart Goldstein have a licensing agreement with VigiLanz corporation for which they receive royalties. VigiLanz corporation markets an AKI screening algorithm to support NINJA that was used for patient identification and data analysis in this study. VigiLanz had no involvement in the design, analysis, or data interpretation of this study and did not participate in the writing or submission of the manuscript. The first draft of the manuscript was written by Hailey Gavigan who received no monetary support.
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Gavigan, H.W., Slagle, C.L., Krallman, K.A. et al. Blood transfusion rates in Baby NINJA (Nephrotoxic Injury Negated by Just-in-Time Action)—a single-center experience. Pediatr Nephrol 36, 1901–1905 (2021). https://doi.org/10.1007/s00467-020-04917-5
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DOI: https://doi.org/10.1007/s00467-020-04917-5