This prevented 100 AKI episodes during the 18-month sustainability era.Ī systematic surveillance program to identify high-risk infants can prevent nephrotoxic-induced AKI and has the potential to prevent short and long-term consequences of AKI in critically ill infants.Ĭopyright © 2019 Elsevier Inc. 001) while maintaining a high SCr surveillance rate. 001), and reduction in AKI intensity from 9.1 to 2.9 per 100 susceptible patient-days (P <. 03), reduction in percentage of nephrotoxic medication-AKI from 30.9% to 11.0% (P <. The effort builds off the NINJA (Nephrotoxic Injury Negated by Just-in-Time Action) project, a joint endeavor between Children’s and the Cincinnati Children’s Hospital Medical Center that started in 2011 in non. Differences for 5 metrics across 3 eras were compared: SCr surveillance, high nephrotoxic medication exposure rate (per 1000 patient-days), AKI rate (per 1000 patient-days), nephrotoxin-AKI percentage, and AKI intensity (number of AKI days per 100 susceptible patient-days).Ĭomparing the initiation with sustainability era, there was a reduction in high nephrotoxic medication exposures from 16.4 to 9. The initiative, called Baby NINJA, was so successful it is now being validated at several other major children’s hospitals. The study was divided into 3 eras: pre-Nephrotoxic Injury Negated by Just-in-time Action (NINJA), initiation, and sustainability. If infants met criteria, a daily serum creatinine (SCr) was obtained until 2 days after end of exposure or end of AKI, whichever occurred last. Infants were screened for high-risk nephrotoxic medication exposure (≥3 nephrotoxic medication within 24 hours or ≥4 calendar days of an intravenous aminoglycoside). Quality improvement project that occurred between March 2015 and September 2017 in a single center, level IV neonatal intensive care unit. To test if acute kidney injury (AKI) is preventable in patients in the neonatal intensive care unit and if infants at high-risk of nephrotoxic medication-induced AKI can be identified using a systematic surveillance program previously used in the pediatric non-intensive care unit setting.
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