Impact of bedside ultrasound to reduce the incidence of acute renal injury in high-risk surgical patients: a randomized clinical trial.

Autor: Ravetti CG; Department of Internal Medicine, School of Medicine and Hospital das Clínicas-Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil. ceciliag.ravetti@gmail.com., Vassallo PF; Hospital das Clínicas: Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil., Ataíde TBLS; Hospital das Clínicas: Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.; Empresa Brasileira de Serviços Hospitalares (EBSERH), Brasília, Brazil., Bragança RD; Hospital das Clínicas: Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.; Empresa Brasileira de Serviços Hospitalares (EBSERH), Brasília, Brazil., Dos Santos ACS Jr; Hospital das Clínicas: Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.; Empresa Brasileira de Serviços Hospitalares (EBSERH), Brasília, Brazil., Lima Bastos F; Department of Internal Medicine, School of Medicine and Hospital das Clínicas-Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil., Rocha GC; Department of Internal Medicine, School of Medicine and Hospital das Clínicas-Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil., Muniz MR; Department of Internal Medicine, School of Medicine and Hospital das Clínicas-Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil., Borges IN; Department of Internal Medicine, School of Medicine and Hospital das Clínicas-Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil.; Empresa Brasileira de Serviços Hospitalares (EBSERH), Brasília, Brazil., Marinho CC; Department of Internal Medicine, School of Medicine and Hospital das Clínicas-Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil., Nobre V; Postgraduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, Department of Internal Medicine, School of Medicine and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Jazyk: angličtina
Zdroj: Journal of ultrasound [J Ultrasound] 2023 Jun; Vol. 26 (2), pp. 449-457. Date of Electronic Publication: 2022 Dec 02.
DOI: 10.1007/s40477-022-00730-y
Abstrakt: Purpose: This study aimed to determine whether performing bedside ultrasound impacts the occurrence of acute kidney injury (AKI) in the immediate postoperative period (POP) of high-risk surgery patients.
Methods: POP patients were randomly assigned to two groups: (i) ultrasound (US) group, in which hemodynamic management was guided with clinical parameters supplemented with the bedside US findings; (ii) control group, hemodynamic management based solely on clinical parameters. Two exams were performed in the first 24 h of admission.
Results: Fifty-one patients were randomized to the US group and 60 to the control group. There was no significant difference for incidence of AKI in both groups assessed 12 h (31.4% vs 35.0%, P = 0.84), 24 h (27.5% vs 23.3%, P = 0.66), or 7 days (17.6 vs 8.3%, P = 0.16) after surgery. No difference was found in the amounts of volume administered over the first 12 h (1000 [500-2000] vs. 1000 [500-1500], P = 0.72) and 24 h (1000 [0-1500] vs. 1000 [0-1500], P = 0.95) between the groups. Patients without AKI in the control group received higher amounts of volume during the ICU stay.
Conclusion: The use of bedside US in the immediate postoperative period of high-risk surgery did not show benefits in reducing AKI incidence.
(© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)
Databáze: MEDLINE
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