Early warning value of urinary oxygen tension monitoring for paediatric intensive care unit sepsis-associated acute kidney injury: a retrospective study

Abstract

Abstract Backgroud To explore whether monitoring of non-invasive urine oxygen tension (PuO2) for 3 consecutive days can reflect renal medulla microcirculation injury early and whether changes in PuO2 (△PuO2) have reliable early diagnostic value for sepsis-associated acute kidney injury (SA-AKI). Methods Twenty-four patients who were hospitalised for more than 48 h in our hospital and were diagnosed with sepsis were retrospectively divided into non-SA-AKI group and SA-AKI group according to the occurrence of acute kidney injury (AKI). The general and oxygen metabolism data of the two groups were compared. The results of urine analysis (PuO2, PuCO2, and urinary lactic acid) for 3 consecutive days were compared with common clinical kidney injury indices, and a changing trend was observed. Results In the PICU, a total of 24 patients with sepsis were included (14 males, 58.33%; mean age, 5 years), with 15 cases in the non-SA-AKI group and 9 cases in the SA-AKI group, with incidence of SA-AKI being 37.5%. PuO2 gradually decreased from D0 to D2 in the SA-AKI group; PuCO2 increased naturally. The variation trend of PuO2 was statistically significant in D1-D0, D2-D0, and D2-D1 (P<0.05), and the △PuO2 of D2-D0 (10.83±25.69 vs. -41.13±34.98, P=0.001). The early diagnostic value of PuO2 was significant (AUC=0.885, 95% CI: 0.704–1.000). Conclusions Three consecutive days of PuO2 monitoring can reflect early renal medullary microcirculation injury, and △PuO2 has early diagnostic value for SA-AKI.