Date of Graduation

5-2020

Document Type

Thesis

Degree Name

Bachelor of Science in Nursing

Degree Level

Undergraduate

Department

Nursing

Advisor/Mentor

Dr. Allison Scott

Committee Member/Reader

Dr. Kelly Vowell-Johnson

Committee Member/Second Reader

Dr. Kelly Vowell-Johnson

Abstract

The purpose of this literature review is to evaluate current research surrounding management of pediatric patients after cardiac surgery. Acute kidney injury (AKI) and neurodevelopmental deficits are the main discussion topics. This review analyzes the causes, risk factors, and effects of AKI. The diagnostic and management methods surrounding AKI are compared, and diagnostic approaches such as serum Cystatin C and fibroblast growth factor 23 are analyzed as potential future replacements to serum creatinine. The modality of renal replacement therapy is evaluated, and early initiation of peritoneal dialysis is preferred. This review discusses the most common causes, effects, and management of neurodevelopmental delays. Interventions in the preoperative, perioperative, and postoperative stages are examined, and the research indicates that preoperative factors are most influential in determining patient status. Neuromotor and cognitive delays are considered to be the most common adverse effects pediatric patients face after cardiac surgery. Both the AKI and neurodevelopmental studies lack sufficient patient populations, and more findings are needed to validate best practice evidence.

Keywords

neurodevelopment, acute kidney injury, congenital heart disease, pediatric, cardiac surgery, ICU

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