Goal-directed therapy in patients with early acute kidney injury: a multicenter randomized controlled trial
Clinics
; 73: e327, 2018. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-974933
Biblioteca responsável:
BR1.1
ABSTRACT
OBJECTIVES:
Acute kidney injury is associated with many conditions, and no interventions to improve the outcomes of established acute kidney injury have been developed. We performed this study to determine whether goal-directed therapy conducted during the early stages of acute kidney injury could change the course of the disease.METHODS:
This was a multicenter prospective randomized controlled study. Patients with early acute kidney injury in the critical care unit were randomly allocated to a standard care (control) group or a goal-directed therapy group with 8h of intensive treatment to maximize oxygen delivery, and all patients were evaluated during a period of 72h. ClinicalTrials.gov NCT02414906.RESULTS:
A total of 143 patients were eligible for the study, and 99 patients were randomized. Central venous oxygen saturation was significantly increased and the serum lactate level significantly was decreased from baseline levels in the goal-directed therapy group (p=0.001) compared to the control group (p=0.572). No significant differences in the change in serum creatinine level (p=0.96), persistence of acute kidney injury beyond 72h (p=0.064) or the need for renal replacement therapy (p=0.82) were observed between the two groups. In-hospital mortality was significantly lower in the goal-directed therapy group than in the control group (33% vs. 51%; RR 0.61, 95% CI 0.37-1.00, p=0.048, number needed to treat=5).CONCLUSIONS:
Goal-directed therapy for patients in the early stages of acute kidney injury did not change the disease course.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
ODS3 - Meta 3.8 Atingir a cobertura universal de saúde
/
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Arranjos de Entrega
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Objetivo 9: Redução de doenças não transmissíveis
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Neoplasias do Rim, Pelve Renal e Ureteral
Base de dados:
LILACS
Assunto principal:
Terapia Precoce Guiada por Metas
Tipo de estudo:
Ensaio clínico controlado
/
Estudo observacional
/
Fatores de risco
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Clinics
Assunto da revista:
Medicina
Ano de publicação:
2018
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Barretos Cancer Hospital/BR
/
Divisao de Nefrologia/BR
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Faculdade de Medicina de Sao Jose do Rio Preto/BR
/
Hospital do Servidor Publico Estadual (HSPE)/BR
/
Universidade de Sao Paulo/BR