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Early acid-base and...
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Bellomo, Rinaldo
(author)
Early acid-base and blood pressure effects of continuous renal replacement therapy intensity in patients with metabolic acidosis
- Article/chapterEnglish2013
Publisher, publication year, extent ...
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2013-01-11
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Springer Science and Business Media LLC,2013
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-199863
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-199863URI
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https://doi.org/10.1007/s00134-012-2800-0DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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PURPOSE:In acute kidney injury patients, metabolic acidosis is common. Its severity, duration, and associated changes in mean arterial pressure (MAP) and vasopressor therapy may be affected by the intensity of continuous renal replacement therapy (CRRT). We aimed to compare key aspects of acidosis and MAP and vasopressor therapy in patients treated with two different CRRT intensities.METHODS:We studied a nested cohort of 115 patients from two tertiary intensive care units (ICUs) within a large multicenter randomized controlled trial treated with lower intensity (LI) or higher intensity (HI) CRRT.RESULTS:Levels of metabolic acidosis at randomization were similar [base excess (BE) of -8 ± 8 vs. -8 ± 7 mEq/l; p = 0.76]. Speed of BE correction did not differ between the two groups. However, the HI group had a greater increase in MAP from baseline to 24 h (7 ± 3 vs. 0 ± 3 mmHg; p < 0.01) and a greater decrease in norepinephrine dose (from 12.5 to 3.5 vs. 5 to 2.5 μg/min; p < 0.05). The correlation (r) coefficients between absolute change in MAP and norepinephrine (NE) dose versus change in BE were 0.05 and -0.37, respectively.CONCLUSIONS:Overall, LI and HI CRRT have similar acid-base effects in patients with acidosis. However, HI was associated with greater improvements in MAP and vasopressor requirements (clinical trial no. NCT00221013).
Added entries (persons, corporate bodies, meetings, titles ...)
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Lipcsey, MiklosUppsala universitet,Anestesiologi och intensivvård,ANZICS CTG, Level 3, 10 Ievers St, Carlton, VIC, 3053, Australia(Swepub:uu)milip123
(author)
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Calzavacca, Paolo
(author)
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Haase, Michael
(author)
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Haase-Fielitz, Anjia
(author)
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Licari, Elisa
(author)
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Tee, Augustine
(author)
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Cole, Louise
(author)
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Cass, Alan
(author)
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Finfer, Simon
(author)
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Gallagher, Martin
(author)
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Lee, Joanne
(author)
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Lo, Serigne
(author)
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McArthur, Colin
(author)
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McGuinness, Shay
(author)
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Myburgh, John
(author)
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Scheinkestel, Carlos
(author)
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Uppsala universitetAnestesiologi och intensivvård
(creator_code:org_t)
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In:Intensive Care Medicine: Springer Science and Business Media LLC39:3, s. 429-4360342-46421432-1238
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Bellomo, Rinaldo
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Lipcsey, Miklos
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Calzavacca, Paol ...
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Haase, Michael
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Haase-Fielitz, A ...
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Licari, Elisa
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Tee, Augustine
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Cole, Louise
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Cass, Alan
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Finfer, Simon
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Gallagher, Marti ...
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Lee, Joanne
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Lo, Serigne
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McArthur, Colin
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McGuinness, Shay
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Myburgh, John
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Scheinkestel, Ca ...
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Intensive Care M ...
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Uppsala University