Journals / Türk Yoğun Bakım Dergisi / 2020 / Cilt: 18 - Sayı: 1

Renal Resistive Index is Unsusceptible to Systemic Hemodynamics in Fluid Responsive Critically Ill Patients

Sıvı Yanıtlı Kritik Yoğun Bakım Hastalarında Renal Rezistif İndeks Ölçümü Sistemik Hemodinamik Parametrelerden Etkilenmez

Pages
35–42
Publication Date
2022-11-06
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Repeated measures ANOVA method was used for statistical analysis and p

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: The primary goal of fluid resuscitation in critically ill patients is to improveoxygen delivery to ensure adequate organ perfusion.
📊
Key Findings & Data:This study aimed to evaluate changes in the renal resistive index (RRI) and tocompare these changes with hemodynamic parameters after fluid challenge in fluid responsivecritically ill patients.Materials and Methods: Thirty patients older than 18 years who underwent sedation and receivedmechanical ventilation were prospectively studied.
💡
Conclusion & Impact:Repeated measures ANOVA method was used for statistical analysis and p
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: The primary goal of fluid resuscitation in critically ill patients is to improveoxygen delivery to ensure adequate organ perfusion. Little evidence is known about renal responseto fluids in the acute phase, so renal monitoring after the fluid challenge is fundamental duringcritical care stay. This study aimed to evaluate changes in the renal resistive index (RRI) and tocompare these changes with hemodynamic parameters after fluid challenge in fluid responsivecritically ill patients.Materials and Methods: Thirty patients older than 18 years who underwent sedation and receivedmechanical ventilation were prospectively studied. Twenty patients were fluid responsive and wereincluded in the study. An increase of cardiac output (CO) by 10% or more after PLR measuredby ultrasonic CO monitor suspected fluid responsiveness. 500 mL of isotonic solution wasadministered intravenously for 30 minutes. CO measurements were performed at 0, 1 and 30minutes. RRI and mean arterial pressure (MAP) were measured by Doppler ultrasonography at 0and 30 minutes. Repeated measures ANOVA method was used for statistical analysis and p

Özet

Amaç: Kritik hastalarda sıvı resüsitasyonunun temel hedefi oksijen sunumunu artırarak organ perfüzyonunun sürdürülmesidir. Yoğun bakımda sıvı tedavisi renal monitorizasyon ilişkisi önemli olup, erken fazda sıvı tedavisine böbreğin yanıtı ile ilişkili literatür bilgisi kısıtlıdır. Bu çalışmada sıvı yanıtlı kritik yoğun bakım hastalarında sıvı replasmanından sonra renal rezistif indeks (RRI) değişimi ve bu değişimin hemodinamik parametrelerle olan ilişkinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Mekanik ventilasyon desteği altında 18 yaşından büyük, sedatize ve sıvı yanıtlı 20 hasta prospektif olarak çalışmaya dahil edildi. Pasif bacak kaldırma testi sonrası non-invaziv kardiyak monitörizasyon cihazında kardiyak outputta (CO) %10 ve daha fazla artış gösterenler sıvı yanıtlı olarak kabul edildi. Bu hastalara 30 dakika içersinde 500 mL izotonik solüsyonu intravenöz verildi. CO ölçümleri 0., 1. ve 30. dakikalarda yapıldı. RRI ve ortalama arteryal basınç (OAB) değerlerinin ölçümleri 0. ve 30. dakikalarda alındı. İstatiksel analiz için tekrarlayan ANOVA yöntemi uygulandı ve p

🔖

Cite This Article

GÜL, F., BİLGİLİ, B., ARSLANTAŞ, M. K., AYHAN, S. Ö., CİNEL, İ. (2022). Renal Resistive Index is Unsusceptible to Systemic Hemodynamics in Fluid Responsive Critically Ill Patients. Türk Yoğun Bakım Dergisi, Cilt: 18 - Sayı: 1, 35–42. https://ajindex.com/articles/655386

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (10)

  1. Marx G, Schindler WA, Mosch C, Albers J, Bauer M, Gnass I, et al. Intravascular volume therapy in adults. Guidelines from the Association of the Scientific Medical Societies in Germany. Eur J Anaesthesiol 2016;33:488-521
  2. Kalantari K, Chang JN, Ronco C, Rosner MH. Assessment of intravascular volume status and volume responsiveness in critically ill patients. Kidney Int 2013;83:1017-28 3. Osman D, Ridel C, Ray P, Monnet X, Anguel N, Richard, et al. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge. Crit Care Med 2007;35:64-8
  3. De Backer D, Taccone FS, Holsten R, Ibrahimi F, Vincent JL. Influence of respiratory rate on stroke volume variation in mechanically ventilated patients. Anesthesiology 2009;110:1092- 7
  4. Monnet X, Rienzo M, Osman D, Anguel N, Christian R, Pinsky MR, et al. Passive leg raising predicts fluid responsiveness in the critically ill. Crit Care Med 2006;34:1402-7
  5. Chong SW, Peyton PJ. A meta-analysis of the accuracy and precision of the ultrasonic cardiac output monitor (USCOM). Anaesthesia 2012;67:1266- 71
  6. Moussa MD, Scolletta S, Fagnoul D, Pasquier P, Brasseur A, Taccone FB, et al. Effects of fluid administration on renal perfusion in critically ill patients. Crit Care 2015;19:250 8. Schnell D, Darmon M. Bedside Doppler ultrasound for the assessment of renal perfusion in the ICU: advantages and limitations of the available techniques. Crit Ultrasound J 2015;7:24
  7. Haitsma Mulier JLG, Rozemeijer S, Röttgering JG, Spoelstra-de Man AME, Elbers PWG, Tuinman PR, et al. Renal resistive index as an early predictor and discriminator of acute kidney injury in critically ill patients; A prospective observational cohort study. PLoS One 2018;11;13:0197967
  8. Deruddre S, Cheisson G, Mazoit JX, Vicaut E, Benhamou D, Duranteau J. Renal arterial resistance in septic shock: effects of increasing mean arterial pressure with norepinephrine on the renal resistive index assessed with Doppler ultrasonography. Intensive Care Med 2007;33:1557-62
  9. Kuznetsova T, Cauwenberghs N, Knez J, Thijs L, Liu YP, Gu YM, et al: Doppler indexes of left ventricular systolic and diastolic flow and central pulse pressure in relation to renal resistive index. Am J Hypertens 2015;28:535-545
  10. Kararmaz A, Arslantas MK, Cinel I. Renal Resistive Index Measurement by Transesophageal Echocardiography: Comparison With Translumbar Ultrasonography and Relation to Acute Kidney Injury. J Cardiothorac Vasc Anesth 2015