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Goal-directed therapy in patients with early acute kidney injury: a multicenter randomized controlled trial
Amendola, Cristina Prata; Silva-Jr, João Manoel; Carvalho, Taisa; Sanches, Luciana Coelho; Silva, Ulysses Vasconcelos de Andrade e; Almeida, Rosana; Burdmann, Emmanuel; Lima, Emerson; Barbosa, Fabiana Ferreira; Ferreira, Renata Souza; Carmona, Maria José C; Malbouisson, Luiz Marcelo Sá; Nogueira, Fernando A M; Auler-Júnior, José Otavio Costa; Lobo, Suzana Margareth.
Afiliación
  • Amendola, Cristina Prata; Barretos Cancer Hospital. Barretos. BR
  • Silva-Jr, João Manoel; Hospital do Servidor Publico Estadual (HSPE). Instituto de Assistencia Medica ao Servidor Publico Estadual. Sao Paulo. BR
  • Carvalho, Taisa; Barretos Cancer Hospital. Barretos. BR
  • Sanches, Luciana Coelho; Barretos Cancer Hospital. Barretos. BR
  • Silva, Ulysses Vasconcelos de Andrade e; Barretos Cancer Hospital. Barretos. BR
  • Almeida, Rosana; Barretos Cancer Hospital. Barretos. BR
  • Burdmann, Emmanuel; Divisao de Nefrologia. Universidade de Sao Paulo. Faculdade de Medicina FMUSP. Sao Paulo. BR
  • Lima, Emerson; Faculdade de Medicina de Sao Jose do Rio Preto. Sao Jose do Rio Preto. BR
  • Barbosa, Fabiana Ferreira; Faculdade de Medicina de Sao Jose do Rio Preto. Sao Jose do Rio Preto. BR
  • Ferreira, Renata Souza; Faculdade de Medicina de Sao Jose do Rio Preto. Sao Jose do Rio Preto. BR
  • Carmona, Maria José C; Universidade de Sao Paulo. Instituto do Coracao (InCor), Faculdade de Medicina,. Divisao de Anestesiologia e Terapia Intensiva Cirurgica. Sao Paulo. BR
  • Malbouisson, Luiz Marcelo Sá; Universidade de Sao Paulo. Instituto do Coracao (InCor), Faculdade de Medicina. Divisao de Anestesiologia e Terapia Intensiva Cirurgica. Sao Paulo. BR
  • Nogueira, Fernando A M; Hospital do Servidor Publico Estadual (HSPE). Instituto de Assistencia Medica ao Servidor Publico Estadual. Sao Paulo. BR
  • Auler-Júnior, José Otavio Costa; Universidade de Sao Paulo. Instituto do Coracao (InCor), Faculdade de Medicina. Divisao de Anestesiologia e Terapia Intensiva Cirurgica. Sao Paulo. BR
  • Lobo, Suzana Margareth; Faculdade de Medicina de Sao Jose do Rio Preto. Sao Jose do Rio Preto. BR
Clinics ; 73: e327, 2018. tab, graf
Article en En | LILACS | ID: biblio-974933
Biblioteca responsable: 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.
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Texto completo: 1 Colección: 01-internacional Banco de datos: LILACS Asunto principal: Tratamiento Precoz Dirigido por Objetivos Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Clinics Asunto de la revista: MEDICINA Año: 2018 Tipo del documento: Article País de afiliación: Brasil

Texto completo: 1 Colección: 01-internacional Banco de datos: LILACS Asunto principal: Tratamiento Precoz Dirigido por Objetivos Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Clinics Asunto de la revista: MEDICINA Año: 2018 Tipo del documento: Article País de afiliación: Brasil