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domingo, 12 de marzo de 2017

Prophylactic hydration to protect renal function

The Bottom Line - March 10, 2017 - By Bradford C
Ref. Nijssen E. The Lancet; published online February 20, 2017 
http://dx.doi.org/10.1016/S0140-6736(17)30057-0
"Clinical Question
In high-risk patients receiving contrast medium, does prophylactic hydration with normal saline compared to no prophylaxis impact the rate of contrast-induced nephropathy?
The Bottom Line
  • Hydration prior to contrast administration may not be necessary in all patients previously thought at risk to develop CIN.
  • However, this trial does not specifically answer the question for my ICU patient. At this stage, intravenous hydration in this population should continue especially if the patient has haemodynamic instability, nephrotoxic drugs and high contrast doses. Patients with GFR < 30 should still receive peri-procedure hydration. With patients at risk of pulmonary oedema, hydration should be used judiciously."