• Clinics · Oct 2018

    Randomized Controlled Trial Multicenter Study

    Goal-directed therapy in patients with early acute kidney injury: a multicenter randomized controlled trial.

    • Cristina Prata Amendola, João Manoel Silva-Jr, Taisa Carvalho, Luciana Coelho Sanches, Silva Ulysses Vasconcelos de Andrade E UVAE Barretos Cancer Hospital, Barretos, SP, BR., Rosana Almeida, Emmanuel Burdmann, Emerson Lima, Fabiana Ferreira Barbosa, Renata Souza Ferreira, Carmona Maria José C MJC Divisao de Anestesiologia e Terapia Intensiva Cirurgica, Instituto do Coracao (InCor), Divisao de Anestesiologia do Hospital das Clinicas HCFMUSP, Malbouisson Luiz Marcelo Sá LMS Divisao de Anestesiologia e Terapia Intensiva Cirurgica, Instituto do Coracao (InCor), Divisao de Anestesiologia do Hospital das Clinicas , Fernando A M Nogueira, José Otavio Costa Auler-Júnior, and Suzana Margareth Lobo.
    • Barretos Cancer Hospital, Barretos, SP, BR.
    • Clinics (Sao Paulo). 2018 Oct 29; 73: e327.

    ObjectivesAcute 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.MethodsThis 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.ResultsA 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).ConclusionsGoal-directed therapy for patients in the early stages of acute kidney injury did not change the disease course.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…