Department of Pediatrics Annual Report - 2014

Page 20

Predict to Prevent A non-invasive method to measure oxygen in the kidney during congenital heart surgery could prevent injury

The Stollery Children’s Hospital and the Mazankowski Alberta Heart Institute together perform one of the highest numbers of pediatric cardiac surgeries in Canada. More than 30 per cent of children who undergo cardiac surgery will develop acute kidney injury (AKI). Children who develop AKI often have a more difficult recovery after surgery, with some requiring dialysis. They may also be more likely to develop further kidney problems later in life. As a pediatric nephrologist with the Department of Pediatrics, AKI researcher Dr. Catherine Morgan wants to know what causes this injury after cardiac surgery and how we can detect or predict it earlier than what doctors are currently able to do. “When in surgery, the child is placed on a heart/lung bypass machine to manage blood and oxygen flow in the body while the heart is being repaired. The heart surgery, and being on bypass, can alter the child’s normal blood flow to the kidney and vary oxygenation. We want to know how these complex changes affect the kidney.”

Near Infrared Spectroscopy (NIRS) is commonly used to measure brain oxygenation during heart surgery in children. A sensor is applied to the skin and emits specific wavelengths of light. It gets information back about how the tissue underlying it absorbs this light. Morgan looked to NIRS to monitor the kidneys as well. NIRS sensors are being applied to the region on the back overlying the kidney of the children during surgery. Morgan hopes the results of this research will help physicians predict those most likely to develop AKI early. This would allow for a more proactive approach in preventing injury and provide enhanced patient support to those at higher risk by, for example, helping to decide which children need a dialysis catheter to be placed preemptively during surgery. This project, funded by the Women & Children’s Health Research Institute, is in collaboration with Drs. Dominic Cave, anesthesiologist and intensivist, Lindsay Ryerson, intensivist, and Mohammed Al-Aklabi, cardiac surgeon. “The department has a very strong collaborative environment between clinicians and investigators,” says Morgan. “This project wouldn’t have been possible without this collaboration.” ~ KB Dr. Catherine Morgan is a pediatric nephrologist and assistant professor in the Division of Nephrology.