التفاصيل البيبلوغرافية
| العنوان: |
Restrictive fluid management versus usual care in acute kidney injury (REVERSE-AKI): a pilot randomized controlled feasibility trial. |
| المؤلفون: |
Vaara, Suvi T., Ostermann, Marlies, Bitker, Laurent, Schneider, Antoine, Poli, Elettra, Hoste, Eric, Fierens, Jan, Joannidis, Michael, Zarbock, Alexander, van Haren, Frank, Prowle, John, Selander, Tuomas, Bäcklund, Minna, Pettilä, Ville, Bellomo, Rinaldo, on behalf of the REVERSE-AKI study team, Vaara, Suvi, Eastwood, Glenn, Byrne, Liam, Nourse, Mary |
| المصدر: |
Intensive Care Medicine; Jun2021, Vol. 47 Issue 6, p665-673, 9p, 1 Diagram, 3 Charts, 1 Graph |
| مصطلحات موضوعية: |
ACUTE kidney failure, CRITICALLY ill patient care, KIDNEY transplantation, WATER-electrolyte balance (Physiology), RENAL replacement therapy, PILOT projects, RESEARCH, FLUID therapy, RESEARCH methodology, MEDICAL cooperation, EVALUATION research, CATASTROPHIC illness, COMPARATIVE studies |
| مصطلحات جغرافية: |
EUROPE, AUSTRALIA |
| مستخلص: |
Purpose: We compared a restrictive fluid management strategy to usual care among critically ill patients with acute kidney injury (AKI) who had received initial fluid resuscitation.Methods: This multicenter feasibility trial randomized 100 AKI patients 1:1 in seven ICUs in Europe and Australia. Restrictive fluid management included targeting negative or neutral daily fluid balance by minimizing fluid input and/or enhancing urine output with diuretics administered at the discretion of the clinician. Fluid boluses were administered as clinically indicated. The primary endpoint was cumulative fluid balance 72 h from randomization.Results: Mean (SD) cumulative fluid balance at 72 h from randomization was - 1080 mL (2003 mL) in the restrictive fluid management arm and 61 mL (3131 mL) in the usual care arm, mean difference (95% CI) - 1148 mL (- 2200 to - 96) mL, P = 0.033. Median [IQR] duration of AKI was 2 [1-3] and 3 [2-7] days, respectively (median difference - 1.0 [- 3.0 to 0.0], P = 0.071). Altogether, 6 out of 46 (13%) patients in the restrictive fluid management arm and 15 out of 50 (30%) in the usual care arm received renal replacement therapy (RR 0.42; 95% CI 0.16-0.91), P = 0.043. Cumulative fluid balance at 24 h and 7 days was lower in the restrictive fluid management arm. The dose of diuretics was not different between the groups. Adverse events occurred more frequently in the usual care arm.Conclusions: In critically ill patients with AKI, a restrictive fluid management regimen resulted in lower cumulative fluid balance and less adverse events compared to usual care. Larger trials of this intervention are justified. [ABSTRACT FROM AUTHOR] |
|
Copyright of Intensive Care Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
