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IVC Measurements in Critically Ill Patients with Acute Renal Failure

OBJECTIVE: To determine whether the inferior vena cava (IVC) measurement by bedside ultrasound (US-IVC) predicts improvement in renal function in patients with acute kidney injury (AKI). DESIGN: Prospective observational study. SETTING: Medical intensive care unit. PATIENTS: 33 patients with AKI wer...

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Autores principales: Jambeih, Rami, Keddissi, Jean I., Youness, Houssein A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605903/
https://www.ncbi.nlm.nih.gov/pubmed/29057120
http://dx.doi.org/10.1155/2017/3598392
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author Jambeih, Rami
Keddissi, Jean I.
Youness, Houssein A.
author_facet Jambeih, Rami
Keddissi, Jean I.
Youness, Houssein A.
author_sort Jambeih, Rami
collection PubMed
description OBJECTIVE: To determine whether the inferior vena cava (IVC) measurement by bedside ultrasound (US-IVC) predicts improvement in renal function in patients with acute kidney injury (AKI). DESIGN: Prospective observational study. SETTING: Medical intensive care unit. PATIENTS: 33 patients with AKI were included. INTERVENTION: US-IVC was done on admission. The patients' management was done by the primary teams, who were unaware of the US-IVC findings. Two groups of patients were identified. Group 1 included patients who were managed in concordance with their US-IVC (potential volume responders who had a positive fluid balance at 48 h after admission and potential volume nonresponders who had an even or negative fluid balance at 48 hours after admission). Group 2 included patients in whom the fluid management was discordant with their US-IVC. MEASUREMENTS AND MAIN RESULTS: At 48 hours, Group 1 patients had a greater improvement in creatinine [85% versus 31%, p = 0.0002], creatinine clearance (78 ± 93% versus 8 ± 64%, p = 0.002), and urine output (0.86 ± 0.54 versus 0.45 ± 0.36 ml/Kg/h, p = 0.03). CONCLUSION: In critically ill patients with AKI, concurrence of fluid therapy with IVC predicted fluid management, as assessed by bedside ultrasound, was associated with improved renal function at 48 hours. This trial is registered with ClinicalTrials.gov registration number: NCT02064244.
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spelling pubmed-56059032017-10-22 IVC Measurements in Critically Ill Patients with Acute Renal Failure Jambeih, Rami Keddissi, Jean I. Youness, Houssein A. Crit Care Res Pract Clinical Study OBJECTIVE: To determine whether the inferior vena cava (IVC) measurement by bedside ultrasound (US-IVC) predicts improvement in renal function in patients with acute kidney injury (AKI). DESIGN: Prospective observational study. SETTING: Medical intensive care unit. PATIENTS: 33 patients with AKI were included. INTERVENTION: US-IVC was done on admission. The patients' management was done by the primary teams, who were unaware of the US-IVC findings. Two groups of patients were identified. Group 1 included patients who were managed in concordance with their US-IVC (potential volume responders who had a positive fluid balance at 48 h after admission and potential volume nonresponders who had an even or negative fluid balance at 48 hours after admission). Group 2 included patients in whom the fluid management was discordant with their US-IVC. MEASUREMENTS AND MAIN RESULTS: At 48 hours, Group 1 patients had a greater improvement in creatinine [85% versus 31%, p = 0.0002], creatinine clearance (78 ± 93% versus 8 ± 64%, p = 0.002), and urine output (0.86 ± 0.54 versus 0.45 ± 0.36 ml/Kg/h, p = 0.03). CONCLUSION: In critically ill patients with AKI, concurrence of fluid therapy with IVC predicted fluid management, as assessed by bedside ultrasound, was associated with improved renal function at 48 hours. This trial is registered with ClinicalTrials.gov registration number: NCT02064244. Hindawi 2017 2017-09-05 /pmc/articles/PMC5605903/ /pubmed/29057120 http://dx.doi.org/10.1155/2017/3598392 Text en Copyright © 2017 Rami Jambeih et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Jambeih, Rami
Keddissi, Jean I.
Youness, Houssein A.
IVC Measurements in Critically Ill Patients with Acute Renal Failure
title IVC Measurements in Critically Ill Patients with Acute Renal Failure
title_full IVC Measurements in Critically Ill Patients with Acute Renal Failure
title_fullStr IVC Measurements in Critically Ill Patients with Acute Renal Failure
title_full_unstemmed IVC Measurements in Critically Ill Patients with Acute Renal Failure
title_short IVC Measurements in Critically Ill Patients with Acute Renal Failure
title_sort ivc measurements in critically ill patients with acute renal failure
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605903/
https://www.ncbi.nlm.nih.gov/pubmed/29057120
http://dx.doi.org/10.1155/2017/3598392
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