Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Crit Care Resusc ; 16(4): 274-9, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25437221

ABSTRACT

BACKGROUND: 0.9% saline is the most commonly used intravenous (IV) fluid in the world. However, recent data raise the possibility that, compared with buffered crystalloid fluids such as Plasma-Lyte 148, the administration of 0.9% saline to intensive care unit patients might increase their risk of acute kidney injury (AKI). OBJECTIVE: To describe the protocol for the 0.9% Saline v Plasma-Lyte 148 for ICU Fluid Therapy (SPLIT) study. METHODS: This is a multicentre, cluster-randomised, double crossover feasibility study to be conducted in four New Zealand tertiary ICUs over a 28-week period and will enroll about 2300 participants. All ICU patients who need crystalloid IV fluid therapy (except those with established renal failure needing dialysis and those admitted to the ICU for palliative care) will be enrolled. Participating ICUs will be randomly assigned to 0.9% saline or Plasma-Lyte 148 as the routine crystalloid IV fluid, in a blinded fashion, in four alternating 7-week blocks. MAIN OUTCOME MEASURES: The primary outcome will be the proportion of patients who develop AKI in the ICU. Secondary outcomes will include the difference between the most recent serum creatinine level measured before study enrollment and the peak serum creatinine level in the ICU; use of renal replacement therapy; and ICU and in hospital mortality. All analyses will be conducted on an intention-to-treat basis. RESULTS AND CONCLUSION: The SPLIT study started on 1 April 2014 and will provide preliminary data on the comparative effectiveness of using 0.9% saline v Plasma- Lyte 148 as the routine IV fluid therapy in ICU patients.


Subject(s)
Cardioplegic Solutions/therapeutic use , Clinical Protocols , Fluid Therapy/methods , Acute Kidney Injury , Blood Flow Velocity , Creatinine/blood , Critical Care , Cross-Over Studies , Gluconates/therapeutic use , Humans , Magnesium Chloride/therapeutic use , Potassium Chloride/therapeutic use , Renal Artery/physiopathology , Research Design , Sodium Acetate/therapeutic use , Sodium Chloride/therapeutic use
2.
Kidney Int ; 77(11): 1020-30, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20164823

ABSTRACT

We performed a double-blind placebo-controlled trial to study whether early treatment with erythropoietin could prevent the development of acute kidney injury in patients in two general intensive care units. As a guide for choosing the patients for treatment we measured urinary levels of two biomarkers, the proximal tubular brush border enzymes gamma-glutamyl transpeptidase and alkaline phosphatase. Randomization to either placebo or two doses of erythropoietin was triggered by an increase in the biomarker concentration product to levels above 46.3, with a primary outcome of relative average plasma creatinine increase from baseline over 4 to 7 days. Of 529 patients, 162 were randomized within an average of 3.5 h of a positive sample. There was no difference in the incidence of erythropoietin-specific adverse events or in the primary outcome between the placebo and treatment groups. The triggering biomarker concentration product selected patients with more severe illness and at greater risk of acute kidney injury, dialysis, or death; however, the marker elevations were transient. Early intervention with high-dose erythropoietin was safe but did not alter the outcome. Although these two urine biomarkers facilitated our early intervention, their transient increase compromised effective triaging. Further, our study showed that a composite of these two biomarkers was insufficient for risk stratification in a patient population with a heterogeneous onset of injury.


Subject(s)
Erythropoietin/administration & dosage , Hematinics/administration & dosage , Kidney Diseases/prevention & control , Acute Disease , Aged , Alkaline Phosphatase/urine , Biomarkers/blood , Biomarkers/urine , Creatinine/blood , Double-Blind Method , Drug Administration Schedule , Erythropoietin/adverse effects , Female , Hematinics/adverse effects , Humans , Intensive Care Units , Kidney Diseases/etiology , Kidney Diseases/metabolism , Male , Middle Aged , New Zealand , Patient Selection , Placebo Effect , Predictive Value of Tests , Prospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome , Triage , gamma-Glutamyltransferase/urine
SELECTION OF CITATIONS
SEARCH DETAIL
...