Cargando…

Determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (DOnE RRT)

INTRODUCTION: Renal replacement therapy (RRT) is a complex and expensive form of life-sustaining therapy, reserved for our most acutely ill patients. While a number of randomised trials have evaluated the optimal timing to start RRT among critically ill patients in the intensive care unit (ICU), the...

Descripción completa

Detalles Bibliográficos
Autores principales: Al Saadon, Abdalrhman, Katulka, Riley, Sebastianski, Meghan, Featherstone, Robin, Vandermeer, Ben, Gibney, R T Noel, Rewa, Oleksa G, Bagshaw, Sean M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254408/
https://www.ncbi.nlm.nih.gov/pubmed/30478115
http://dx.doi.org/10.1136/bmjopen-2018-023306
_version_ 1783373708886278144
author Al Saadon, Abdalrhman
Katulka, Riley
Sebastianski, Meghan
Featherstone, Robin
Vandermeer, Ben
Gibney, R T Noel
Rewa, Oleksa G
Bagshaw, Sean M
author_facet Al Saadon, Abdalrhman
Katulka, Riley
Sebastianski, Meghan
Featherstone, Robin
Vandermeer, Ben
Gibney, R T Noel
Rewa, Oleksa G
Bagshaw, Sean M
author_sort Al Saadon, Abdalrhman
collection PubMed
description INTRODUCTION: Renal replacement therapy (RRT) is a complex and expensive form of life-sustaining therapy, reserved for our most acutely ill patients. While a number of randomised trials have evaluated the optimal timing to start RRT among critically ill patients in the intensive care unit (ICU), there has been a paucity of trials providing guidance on when and under what circumstances to ideally liberate a patient from RRT. We are conducting a systematic review and meta-analysis to identify clinical and biochemical markers that predict kidney recovery and successful liberation from acute RRT among critically ill patients with acute kidney injury. METHODS AND ANALYSIS: Our comprehensive search strategy was developed in consultation with a research librarian and independently peer-reviewed by a second librarian. We will search electronic databases: Ovid Medline, Ovid Embase and Wiley Cochrane Library. Selected grey literature sources will also be searched. Our search strategies will focus on concepts related to RRT (ie, intermittent haemodialysis, slow low-efficiency dialysis, continuous renal replacement therapy), intensive care (ie, involving any ICU setting) and discontinuation of therapy (ie, either clinical, physiological and biochemical parameters of weaning acute RRT) from 1990 to October 10, 2017. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. Studies will, where possible, be pooled in statistical meta-analysis. When deemed sufficiently clinically homogenous, and we have four or more studies reporting, sensitivities and specificities will be pooled simultaneously using a hierarchical summary receiver operator characteristic curve and bivariate analysis. ETHICS AND DISSEMINATION: Our systematic review will synthesise the literature on clinical and biochemical markers that predict liberation from RRT. Research ethics approval is not required. TRIAL REGISTRATION NUMBER: CRD42018074615.
format Online
Article
Text
id pubmed-6254408
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-62544082018-12-11 Determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (DOnE RRT) Al Saadon, Abdalrhman Katulka, Riley Sebastianski, Meghan Featherstone, Robin Vandermeer, Ben Gibney, R T Noel Rewa, Oleksa G Bagshaw, Sean M BMJ Open Intensive Care INTRODUCTION: Renal replacement therapy (RRT) is a complex and expensive form of life-sustaining therapy, reserved for our most acutely ill patients. While a number of randomised trials have evaluated the optimal timing to start RRT among critically ill patients in the intensive care unit (ICU), there has been a paucity of trials providing guidance on when and under what circumstances to ideally liberate a patient from RRT. We are conducting a systematic review and meta-analysis to identify clinical and biochemical markers that predict kidney recovery and successful liberation from acute RRT among critically ill patients with acute kidney injury. METHODS AND ANALYSIS: Our comprehensive search strategy was developed in consultation with a research librarian and independently peer-reviewed by a second librarian. We will search electronic databases: Ovid Medline, Ovid Embase and Wiley Cochrane Library. Selected grey literature sources will also be searched. Our search strategies will focus on concepts related to RRT (ie, intermittent haemodialysis, slow low-efficiency dialysis, continuous renal replacement therapy), intensive care (ie, involving any ICU setting) and discontinuation of therapy (ie, either clinical, physiological and biochemical parameters of weaning acute RRT) from 1990 to October 10, 2017. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. Studies will, where possible, be pooled in statistical meta-analysis. When deemed sufficiently clinically homogenous, and we have four or more studies reporting, sensitivities and specificities will be pooled simultaneously using a hierarchical summary receiver operator characteristic curve and bivariate analysis. ETHICS AND DISSEMINATION: Our systematic review will synthesise the literature on clinical and biochemical markers that predict liberation from RRT. Research ethics approval is not required. TRIAL REGISTRATION NUMBER: CRD42018074615. BMJ Publishing Group 2018-11-25 /pmc/articles/PMC6254408/ /pubmed/30478115 http://dx.doi.org/10.1136/bmjopen-2018-023306 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Intensive Care
Al Saadon, Abdalrhman
Katulka, Riley
Sebastianski, Meghan
Featherstone, Robin
Vandermeer, Ben
Gibney, R T Noel
Rewa, Oleksa G
Bagshaw, Sean M
Determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (DOnE RRT)
title Determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (DOnE RRT)
title_full Determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (DOnE RRT)
title_fullStr Determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (DOnE RRT)
title_full_unstemmed Determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (DOnE RRT)
title_short Determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (DOnE RRT)
title_sort determining the optimal time for liberation from renal replacement therapy in critically ill patients: protocol for a systematic review and meta-analysis (done rrt)
topic Intensive Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254408/
https://www.ncbi.nlm.nih.gov/pubmed/30478115
http://dx.doi.org/10.1136/bmjopen-2018-023306
work_keys_str_mv AT alsaadonabdalrhman determiningtheoptimaltimeforliberationfromrenalreplacementtherapyincriticallyillpatientsprotocolforasystematicreviewandmetaanalysisdonerrt
AT katulkariley determiningtheoptimaltimeforliberationfromrenalreplacementtherapyincriticallyillpatientsprotocolforasystematicreviewandmetaanalysisdonerrt
AT sebastianskimeghan determiningtheoptimaltimeforliberationfromrenalreplacementtherapyincriticallyillpatientsprotocolforasystematicreviewandmetaanalysisdonerrt
AT featherstonerobin determiningtheoptimaltimeforliberationfromrenalreplacementtherapyincriticallyillpatientsprotocolforasystematicreviewandmetaanalysisdonerrt
AT vandermeerben determiningtheoptimaltimeforliberationfromrenalreplacementtherapyincriticallyillpatientsprotocolforasystematicreviewandmetaanalysisdonerrt
AT gibneyrtnoel determiningtheoptimaltimeforliberationfromrenalreplacementtherapyincriticallyillpatientsprotocolforasystematicreviewandmetaanalysisdonerrt
AT rewaoleksag determiningtheoptimaltimeforliberationfromrenalreplacementtherapyincriticallyillpatientsprotocolforasystematicreviewandmetaanalysisdonerrt
AT bagshawseanm determiningtheoptimaltimeforliberationfromrenalreplacementtherapyincriticallyillpatientsprotocolforasystematicreviewandmetaanalysisdonerrt