Comparison of hemodynamic instability among continuous, intermittent and hybrid renal replacement therapy in acute kidney injury: A systematic review of randomized clinical trials.

PURPOSE: To compare hemodynamic instability during continuous, intermittent and hybrid renal replacement therapy (RRT) in critically ill patients, and its association with renal recovery and mortality. MATERIALS AND METHODS: The search was conducted in accordance with the PRISMA guidelines which was registered at the PROSPERO Database (CRD42018086504). Randomized clinical trials (RCTs) involving critically ill patients with acute kidney injury (AKI) treated with continuous, intermittent or hybrid RRT were included. The search was performed using PubMed, Embase and Cochrane databases. RESULTS: Out of 3442 citations retrieved, 12 RCTs were included in the systematic analysis, representing 1419 patients. Most studies (n = 8) did not report differences in hemodynamic parameters across different RTT modalities. The incidence of hypotensive episodes varied from 5 to 60% among the studies. Punctual differences on heart rate and blood pressure were observed among studies. However, studies presented high heterogeneity in terms of outcome definitions and measurement, thus making the conduction of meta-analysis impossible. CONCLUSIONS: There is very few information available regarding hemodynamic tolerance of renal replacement therapy methods. A better standardization of hemodynamic tolerance and further reports are needed before conclusions can be drawn.

Indicações de ceratoplastia: estudo retrospectivo em um Hospital Universitário / Indications of keratoplasty: a retrospective study in a University Hospital

OBJETIVO: Descrever o perfil demográfico-epidemiológico e as indicações de ceratoplastia no Hospital Universitário Santa Terezinha de Joaçaba/SC no período de outubro de 2006 a abril de 2011. MÉTODOS: Os prontuários foram examinados no Centro Oftalmológico Belloto Stock de Joaçaba (SC) e os pacientes foram acompanhados antes e depois da ceratoplastia. Os dados analisados foram cidade de origem, idade, gênero, etnia e indicação da ceratoplastia. RESULTADOS: Foram analisados os prontuários de 85 pacientes em que foram realizadas 100 ceratoplastias. Quanto à origem, 79% dos pacientes provinham da região do Meio-Oeste e os demais de outras regiões de Santa Catarina. A média de idade foi de 38 ± 17,61 anos, variando de 13 a 87. Quanto ao gênero encontrou-se prevalência do sexo masculino em 57,6%. A etnia branca foi declarada por 94,1% dos pacientes e a parda por 5,9%. As indicações de ceratoplastia foram ceratocone em 51 (51%) olhos, retransplante em 15 (15%), todos pacientes provenientes de outros serviços, leucoma pós-herpes em 13 (13%), ceratopatia bolhosa pós-facectomia em 6 (6%), distrofia corneana em 5 (5%), leucoma pós-trauma perfurante em 4 (4%), úlcera bacteriana sem resposta ao tratamento clínico em 3 (3%) e outras causas em 3 (3%). Das 100 ceratoplastias realizadas 98 (98%) foram penetrantes e 2 (2%) lamelares anteriores profundas. CONCLUSÃO: O estudo concluiu que o perfil dos pacientes submetidos à ceratoplastia caracterizou-se como jovem, de etnia branca, com predominância do sexo masculino e as quatro principais indicações de ceratoplastia foram ceratocone, retransplante, leucoma pós-herpes e ceratopatia bolhosa pós-facectomia.

OBJECTIVE: To describe the demographic-epidemiological profile and indications of keratoplasty at the University Hospital Santa Terezinha of Joaçaba (SC) from october 2006 to april 2011. METHODS: The records were obtained from the files of the Eye Center Belloto Stock of Joaçaba (SC), where the patients were accompanied before and after keratoplasty. The data analyzed were city of origin, age, gender, ethnicity and indication of keratoplasty. RESULTS: The medical records of 85 patients were analyzed, who underwent 100 keratoplasties. As to the origin, 79% of patients were in the region of the Midwest and the rest from other regions of Santa Catarina. The average age of patients was 38 ± 17.61 years, ranging from 13 to 87 years. As the gender, male prevalence was 57.6%. The white race was declared by 94.1% of patients and 5.9% for mixed. The indications for keratoplasty were keratoconus in 51 (51%) eyes, regraft in 15 (15%), leucoma post-herpes in 13 (13%), bullous keratopathy after cataract surgery in 6 (6%), corneal dystrophy in 5 (5%), leucoma after penetrating trauma in 4 (4%), bacterial ulcer unresponsive to medical treatment in 3 (3%) and other causes in 3 (3%). Of the 100 keratoplasties performed, 98 (98%) were penetrating and 2 (2%) lamellar. CONCLUSION: The study concluded that the profile of patients undergoing keratoplasty was characterized as a population of young caucasians, with a slight male predominance, and the four most common indications for keratoplasty were keratoconus, regraft, post-herpes leucoma and bullous keratopathy after cataract extraction.