Sodium bicarbonate in the prevention of cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis
| Autor: | Hong-Tao Tie, Min Zhang, Ming-Zhu Luo, Ming-Jing Luo, Qing-Chen Wu, Jing-Yuan Wan |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Letter medicine.medical_treatment Hospital mortality urologic and male genital diseases Critical Care and Intensive Care Medicine chemistry.chemical_compound Postoperative Complications Atrial Fibrillation medicine Humans Renal replacement therapy Cardiac Surgical Procedures Intensive care medicine Randomized Controlled Trials as Topic Sodium bicarbonate Adult patients urogenital system business.industry Research Acute kidney injury Atrial fibrillation Acute Kidney Injury Length of Stay medicine.disease Cardiac surgery Renal Replacement Therapy Sodium Bicarbonate chemistry Meta-analysis business |
| Zdroj: | Critical Care |
| ISSN: | 1466-609X |
| Popis: | Introduction Sodium bicarbonate (SBIC) was reported to be a promising approach to prevent cardiac surgery-associated acute kidney injury (CSA-AKI). However, the results remain controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of SBIC on the prevention of CSA-AKI in adult patients undergoing cardiac surgery. Methods PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of SBIC versus placebo on the prevention of CSA-AKI in adult patients undergoing cardiac surgery were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of CSA-AKI. Meta-analysis was performed using random-effects models. Results Five RCTs involving 1079 patients were included in the meta-analysis. Overall, compared with placebo, SBIC was not associated with a reduced risk of CSA-AKI (relative risk [RR] 0.99; 95% confidence interval [CI] 0.78 to 1.24; P = 0.911). SBIC failed to alter the clinical outcomes of hospital length of stay (weighted mean difference [WMD] 0.23 days; 95%CI −0.88 to 1.33 days; P = 0.688), renal replacement therapy (RR 0.94; 95%CI 0.49 to 1.82; P = 0.861), hospital mortality (RR 1.37; 95%CI 0.46 to 4.13; P = 0.572), postoperative atrial fibrillation (RR 1.02; 95%CI 0.65 to 1.61; P = 0.915). However, SBIC was associated with significant increased risks in longer duration of ventilation (WMD 0.64 hours; 95%CI 0.16 to 1.11 hours; P = 0.008), longer ICU length of stay (WMD 2.06 days; 95%CI 0.54 to 3.58 days; P = 0.008), and increased incidence of alkalemia (RR 2.21; 95%CI 1.42 to 3.42; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink