1. Reducing Mortality in Acute Kidney Injury Patients: Systematic Review and International Web-Based Survey
- Author
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Giovanni, Landoni, Tiziana, Bove, Andrea, Székely, Marco, Comis, Reitze N, Rodseth, Daniela, Pasero, Martin, Ponschab, Marta, Mucchetti, Maria L, Azzolini, Fabio, Caramelli, Gianluca, Paternoster, Giovanni, Pala, Luca, Cabrini, Daniele, Amitrano, Giovanni, Borghi, Antonella, Capasso, Claudia, Cariello, Anna, Carpanese, Paolo, Feltracco, Leonardo, Gottin, Rosetta, Lobreglio, Lorenzo, Mattioli, Fabrizio, Monaco, Francesco, Morgese, Mario, Musu, Laura, Pasin, Antonio, Pisano, Agostino, Roasio, Gianluca, Russo, Giorgio, Slaviero, Nicola, Villari, Annalisa, Vittorio, Mariachiara, Zucchetti, Fabio, Guarracino, Andrea, Morelli, Vincenzo, De Santis, Paolo A, Del Sarto, Antonio, Corcione, Marco, Ranieri, Gabriele, Finco, Alberto, Zangrillo, Rinaldo, Bellomo, Landoni, G., Bove, T., Székely, A., Comis, M., Rodseth, R.N., Pasero, D., Ponschab, M., Mucchetti, M., Azzolini, M.L., Caramelli, F., Paternoster, G., Pala, G., Cabrini, L., Amitrano, D., Borghi, G., Capasso, A., Cariello, C., Carpanese, A., Feltracco, P., Gottin, L., Lobreglio, R., Mattioli, L., Monaco, F., Morgese, F., Musu, M., Pasin, L., Pisano, A., Roasio, A., Russo, G., Slaviero, G., Villari, N., Vittorio, A., Zucchetti, M., Guarracino, F., Morelli, A., De Santis, V., Del Sarto, P.A., Corcione, A., Ranieri, M., Finco, G., Zangrillo, A., Bellomo, R., Landoni, G, Bove, T, Székely, A, Comis, M, Rodseth, Rn, Pasero, D, Ponschab, M, Mucchetti, M, Azzolini, Ml, Caramelli, F, Paternoster, G, Pala, G, Cabrini, L, Amitrano, D, Borghi, G, Capasso, A, Cariello, C, Carpanese, A, Feltracco, P, Gottin, L, Lobreglio, R, Mattioli, L, Monaco, F, Morgese, F, Musu, M, Pasin, L, Pisano, A, Roasio, A, Russo, G, Slaviero, G, Villari, N, Vittorio, A, Zucchetti, M, Guarracino, F, Morelli, A, De Santis, V, Del Sarto, Pa, Corcione, A, Ranieri, M, Finco, G, Zangrillo, A, and Bellomo, R
- Subjects
renal failure ,short term survival ,patient monitoring ,medicine.medical_treatment ,health care survey ,acute renal injury ,hetastarch ,bacterial peritoniti ,Comorbidity ,hemodynamic monitoring ,health belief ,law.invention ,hemofiltration ,contrast induced nephropathy ,burn patient ,law ,consensu ,burn ,web vote ,angiography ,randomized controlled trial (topic) ,hepatorenal syndrome ,physician ,continuous hemodiafiltration ,article ,Acute kidney injury ,Acute Kidney Injury ,continuous infusion ,Intensive care unit ,human immunoglobulin ,clinical practice ,vasopressin, acute kidney failure ,multiple myeloma ,perioperative hemodynamic optimization ,priority journal ,human albumin ,meta analysis (topic) ,nadroparin ,multicenter study (topic) ,sepsi ,Cardiology and Cardiovascular Medicine ,renal replacement therapy ,Reducing mortality in acute kidney injury patients: systematic review and international web-based surve ,radiation injury ,Human ,medicine.drug ,medicine.medical_specialty ,consensus conference ,Contrast-induced nephropathy ,self report ,anesthesia ,survival ,Perioperative Care ,acute kidney failure, acute renal injury, anesthesia, consensus, consensus conference, critical care, mortality, renal failure, survival, web vote ,terlipressin ,critically ill patient ,acute kidney failure ,Monitoring, Intraoperative ,acetylcysteine ,Hemofiltration ,medicine ,Humans ,systematic review, acute kidney failure ,fenoldopam ,furosemide ,Hemodynamic ,Renal replacement therapy ,Intensive care medicine ,plasmapheresi ,Internet ,continuous hemofiltration ,liver cirrhosi ,Septic shock ,business.industry ,hepatorenal syndrome type 1 ,Hemodynamics ,Perioperative ,citric acid ,bleeding ,medicine.disease ,mortality ,web vote, Acute Kidney Injury ,fluid balance ,heart surgery ,drug efficacy ,critical care ,early intervention ,Anesthesiology and Pain Medicine ,hemodialysi ,consensus ,Health Care Surveys ,septic shock ,Terlipressin ,business ,periangiography hemofiltration - Abstract
"OBJECTIVE: To identify all interventions that increase or reduce mortality in patients with acute kidney injury (AKI) and to establish the agreement between stated beliefs and actual practice in this setting.. . DESIGN AND SETTING: Systematic literature review and international web-based survey.. . PARTICIPANTS: More than 300 physicians from 62 countries.. . INTERVENTIONS: Several databases, including MEDLINE/PubMed, were searched with no time limits (updated February 14, 2012) to identify all the drugs/techniques/strategies that fulfilled all the following criteria: (a) published in a peer-reviewed journal, (b) dealing with critically ill adult patients with or at risk for acute kidney injury, and (c) reporting a statistically significant reduction or increase in mortality.. . MEASUREMENTS AND MAIN RESULTS: Of the 18 identified interventions, 15 reduced mortality and 3 increased mortality. Perioperative hemodynamic optimization, albumin in cirrhotic patients, terlipressin for hepatorenal syndrome type 1, human immunoglobulin, peri-angiography hemofiltration, fenoldopam, plasma exchange in multiple-myeloma-associated AKI, increased intensity of renal replacement therapy (RRT), CVVH in severely burned patients, vasopressin in septic shock, furosemide by continuous infusion, citrate in continuous RRT, N-acetylcysteine, continuous and early RRT might reduce mortality in critically ill patients with or at risk for AKI; positive fluid balance, hydroxyethyl starch and loop diuretics might increase mortality in critically ill patients with or at risk for AKI. Web-based opinion differed from consensus opinion for 30% of interventions and self-reported practice for 3 interventions.. . CONCLUSION: The authors identified all interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI and found that there is discordance between participant stated beliefs and actual practice regarding these topics.. . "
- Published
- 2013