Nephrology
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Randomized Controlled Trial
Double-blinded, randomized controlled trial of N-acetylcysteine for prevention of acute kidney injury in high risk patients undergoing off-pump coronary artery bypass.
The aim of this study was to investigate the influence of perioperative N-acetylcysteine (NAC) administration, a known antioxidant, on the incidence of acute kidney injury (AKI) after off-pump coronary bypass surgery (OPCAB) in patients with known risk factors of AKI. ⋯ Perioperative administration of NAC did not prevent the development of postoperative AKI after OPCAB in highly susceptible patients to AKI.
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The kidney is an organ highly susceptible to injury by regional tissue oxygen desaturation during hypoxic episodes. Transcutaneous monitoring of renal tissue oxygen saturation is therefore of increasing interest. The aim of the present study was to compare renal tissue oxygen saturation measured by near-infrared spectroscopy (NIRS) during acute hypoxia in neonates directly on the kidney and transcutaneously. ⋯ There were pronounced and lower renaldirect rSO₂ readings when compared with those of renalskin rSO₂ with significant differences from 25 to 55 s after initiation of hypoxia. Changes of cerebralskin rSO₂ and renalskin rSO₂ were similar. Transcutaneous monitoring of renal tissue oxygen saturation may underestimate acute oxygen desaturation of the kidney during hypoxia in neonates.
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Comparative Study
Effect of ultra-low dose and standard heparin locks on early tunnelled dialysis catheter outcomes in low-risk dialysis patients.
Initial heparin locks instilled after tunnelled dialysis catheter (TDC) insertion can leak causing systemic anticoagulation and also promote staphyloccocal biofilm formation, predisposing to catheter-related infection (CRI). The 1000 U/mL concentration is thus advocated as the optimal dose for preventing catheter bleeding and malfunction. The effect of lower heparin concentrations on further lowering these complications is not known. We compared early TDC outcomes between a non-standard ultra-low (500 U/mL) and standard initial heparin locks (1000 and 5000 U/mL). ⋯ Immediate TDC bleeding, malfunction and CRI rate are not influenced by heparin lock concentrations ≤5000 U/mL in this low-risk cohort. However this needs to be corroborated in higher risk patients.