Efficacy of post-procedural oral hydration volume on risk of contrast-induced acute kidney injury following primary percutaneous coronary intervention: study protocol for a randomized controlled trial
Efficacy of post-procedural oral hydration volume on risk of contrast-induced acute kidney injury following primary percutaneous coronary intervention: study protocol for a randomized controlled trial
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术后口服补水量对初次经皮冠状动脉介入治疗后对比剂诱发的急性肾损伤风险的功效：随机对照试验的研究方案
DOI：
10.1186/s13063-019-3413-5
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发表时间：
2019-05-27
期刊：
影响因子：
2.5
通讯作者：
Liu, Yong
中科院分区：
文献类型：
--
作者：
Song, Feier;Sun, Guoli;Liu, Yong
背景造影剂诱导的急性肾损伤（CI-AKI）导致不良的临床结局。口服水化与水是廉价的，它可能是有效的预防CI-AKI，但它的疗效在接受初级经皮冠状动脉介入治疗（PCI）的患者仍然unknow.Methods/design我们的研究是一个次要的分析数据库从ATTEMPT研究。我们招募了接受直接PCI的ST段抬高型心肌梗死（STEMI）患者。合格患者随机接受围手术期积极（左心室舒张末期压指导）或常规（≤ 500 mL）等渗溶液（0.9% NaCl）静脉补液。主要终点是CI-AKI，定义为在手术后前48 - 72小时内血清肌酐较基线增加> 25%或0.5 mg/dL。所有患者自由饮用不受限制的液体量，记录其体积直到直接PCI后24小时。计算口服水化体积/重量（OHV/W）比。术后口服水化（四分位数）和CI-AKI之间的关联使用控制混杂因素的多变量分析进行评估，包括静脉内水化strategies. DiscussionOur study determined the effects of post-procedure oral hydration on CI-AKI following primary PCI，which is a potential strategy for CI-AKI prevention among patients with STEMI at very high risk. Trial www.example.com，NCT02067195.于2014年2月21日注册。
BackgroundContrast-induced acute kidney injury (CI-AKI) contributes toward unfavorable clinical outcomes. Oral hydration with water is inexpensive and it may be effective in the prevention of CI-AKI, but its efficacy among patients undergoing primary percutaneous coronary intervention (PCI) remains unknown.Methods/designOur study is a secondary analysis on the database from the ATTEMPT study. We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI. Eligible patients received peri-procedural aggressive (left ventricular end-diastolic pressure-guided) or routine (≤ 500 mL) intravenous hydration with an isotonic solution (0.9% NaCl) with randomization. The primary endpoint was CI-AKI, defined as a > 25% or 0.5 mg/dL increase in serum creatinine from baseline during the first 48–72 h post-procedurally. All patients drank unrestricted amounts of fluids freely, the volume of which was recorded until 24 h following primary PCI. Oral hydration volume/weight (OHV/W) ratios were calculated. The association between post-procedural oral hydration (quartiles) and CI-AKI was assessed using multivariable analysis controlling for confounders, including intravenous hydration strategies.DiscussionOur study determined the effects of post-procedural oral hydration on CI-AKI following primary PCI, which is a potential strategy for CI-AKI prevention among patients with STEMI at very high risk.Trial registrationClinicalTrials.gov, NCT02067195. Registered on 21 February 2014.