Distal perfusion during complex aortic arch procedure reduces kidney injury in newborn piglets at moderate hypothermia†.

This article focuses on comparing two perfusion strategies—selective anterograde cerebral perfusion (SACP) and SACP with additional distal perfusion (SACP+DP)—during complex aortic arch procedures in newborns, using a neonate piglet model to assess renal tissue-specific injury. The study found that while histomorphological kidney changes were similar between groups, SACP alone resulted in higher oxidative stress in vulnerable nephron structures and elevated serum levels of neutrophil gelatinase-associated lipocalin (NGAL), an early biomarker of acute kidney injury, compared to SACP+DP. These findings suggest that SACP+DP may better protect renal function by reducing ischemic insult during cardiopulmonary bypass with moderate hypothermia. The study highlights the potential clinical relevance of incorporating distal perfusion to minimize kidney injury in neonatal aortic arch surgery, though it notes limitations including the use of healthy piglets and short-term observation.