Does Chloride Intake at the Early Phase of Septic Shock Resuscitation Impact on Renal Outcome?
Shock
; 56(3): 425-432, 2021 09 01.
Article
em En
| MEDLINE
| ID: mdl-33606477
ABSTRACT
INTRODUCTION:
Fluid administration is one of the first lines of treatment for hemodynamic management of sepsis and septic shock. Studies investigating the effects of chloride-rich fluids including normal saline on renal function report controversial findings.METHODS:
This is a prospective, observational, multicenter study. Patients with septic shock, defined according to Sepsis-2 definition, were eligible. A "high-dose" of chloride was defined as a chloride intake greater than 18âg administrated within the first 48âh of septic shock management. The purpose of this study was to investigate the impact of cumulative chloride infusion within the first 48âh of septic shock resuscitation on acute kidney injury (AKI).RESULTS:
Two hundred thirty-nine patients with septic shock were included. Patients who received a "high-dose" of chloride had significantly higher Sequential Organ Failure Assessment score at the time of enrolment (Pâ<â0.001). Cumulative chloride load was higher in patients requiring renal replacement therapy (RRT) (31.1 vs. 25.2âg/48âh; Pâ<â0.005). Propensity score-weighted regression did not find any association between "high-dose" of chloride and AKI requiring RRT (OR 0.97 [0.88-1.1]; Pâ=â0.69). There was no association between "high-dose" of chloride and worsening kidney function at H48 (OR 0.94 [0.83-1.1]; Pâ=â0.42). There was also no association between "high-dose" of chloride and ICU length of stay (Pâ=â0.61), 28-day mortality (Pâ=â0.83), or hospital mortality (Pâ=â0.89).CONCLUSION:
At the early stage of resuscitation of critically ill patients with septic shock, administration of "high-dose" of chloride (> 18âg/48âh) was not associated with renal prognosis.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Choque Séptico
/
Cloretos
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Injúria Renal Aguda
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Hidratação
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article