Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Anestesiologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000300194 |
Resumo: | Abstract Purpose: Kidney transplantation is the gold-standard treatment for end stage renal disease. Although different hemodynamic variables, like central venous pressure and mean arterial pressure, have been used to guide volume replacement during surgery, the best strategy still ought to be determined. Respiratory arterial Pulse Pressure Variation (PPV) is recognized to be a good predictor of fluid responsiveness for perioperative hemodynamic optimization in operating room settings. The aim of this study was to investigate whether a PPV guided fluid management strategy is better than a liberal fluid strategy during kidney transplantation surgeries. Identification of differences in urine output in the first postoperative hour was the main objective of this study. Methods: We conducted a prospective, single blind, randomized controlled trial. We enrolled 40 patients who underwent kidney transplantation from deceased donors. Patients randomized in the “PPV” group received fluids whenever PPV was higher than 12%, patients in the “free fluid” group received fluids following our institutional standard care protocol for kidney transplantations (10 mL.kg-1. h-1). Results: Urinary output was similar at every time-point between the two groups, urea was statistically different from the third postoperative day with a peak at the fourth postoperative day and creatinine showed a similar trend, being statistically different from the second postoperative day. Urea, creatinine and urine output were not different at the hospital discharge. Conclusion: PPV guided fluid therapy during kidney transplantation significantly improves urea and creatinine levels in the first week after kidney transplantation surgery. |
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Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trialKidney transplantationFluid therapyCreatinineUreaUrineAbstract Purpose: Kidney transplantation is the gold-standard treatment for end stage renal disease. Although different hemodynamic variables, like central venous pressure and mean arterial pressure, have been used to guide volume replacement during surgery, the best strategy still ought to be determined. Respiratory arterial Pulse Pressure Variation (PPV) is recognized to be a good predictor of fluid responsiveness for perioperative hemodynamic optimization in operating room settings. The aim of this study was to investigate whether a PPV guided fluid management strategy is better than a liberal fluid strategy during kidney transplantation surgeries. Identification of differences in urine output in the first postoperative hour was the main objective of this study. Methods: We conducted a prospective, single blind, randomized controlled trial. We enrolled 40 patients who underwent kidney transplantation from deceased donors. Patients randomized in the “PPV” group received fluids whenever PPV was higher than 12%, patients in the “free fluid” group received fluids following our institutional standard care protocol for kidney transplantations (10 mL.kg-1. h-1). Results: Urinary output was similar at every time-point between the two groups, urea was statistically different from the third postoperative day with a peak at the fourth postoperative day and creatinine showed a similar trend, being statistically different from the second postoperative day. Urea, creatinine and urine output were not different at the hospital discharge. Conclusion: PPV guided fluid therapy during kidney transplantation significantly improves urea and creatinine levels in the first week after kidney transplantation surgery.Sociedade Brasileira de Anestesiologia2020-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000300194Revista Brasileira de Anestesiologia v.70 n.3 2020reponame:Revista Brasileira de Anestesiologia (Online)instname:Sociedade Brasileira de Anestesiologia (SBA)instacron:SBA10.1016/j.bjane.2020.04.022info:eu-repo/semantics/openAccessDe Cassai,AlessandroBond,OttaviaMarini,SilviaPanciera,GiulioFurian,LucreziaNeri,FlaviaAndreatta,GiulioRigotti,PaoloFeltracco,Paoloeng2020-09-09T00:00:00Zoai:scielo:S0034-70942020000300194Revistahttps://www.sbahq.org/revista/https://old.scielo.br/oai/scielo-oai.php||sba2000@openlink.com.br1806-907X0034-7094opendoar:2020-09-09T00:00Revista Brasileira de Anestesiologia (Online) - Sociedade Brasileira de Anestesiologia (SBA)false |
dc.title.none.fl_str_mv |
Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial |
title |
Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial |
spellingShingle |
Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial De Cassai,Alessandro Kidney transplantation Fluid therapy Creatinine Urea Urine |
title_short |
Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial |
title_full |
Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial |
title_fullStr |
Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial |
title_full_unstemmed |
Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial |
title_sort |
Pulse pressure variation guided fluid therapy during kidney transplantation: a randomized controlled trial |
author |
De Cassai,Alessandro |
author_facet |
De Cassai,Alessandro Bond,Ottavia Marini,Silvia Panciera,Giulio Furian,Lucrezia Neri,Flavia Andreatta,Giulio Rigotti,Paolo Feltracco,Paolo |
author_role |
author |
author2 |
Bond,Ottavia Marini,Silvia Panciera,Giulio Furian,Lucrezia Neri,Flavia Andreatta,Giulio Rigotti,Paolo Feltracco,Paolo |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
De Cassai,Alessandro Bond,Ottavia Marini,Silvia Panciera,Giulio Furian,Lucrezia Neri,Flavia Andreatta,Giulio Rigotti,Paolo Feltracco,Paolo |
dc.subject.por.fl_str_mv |
Kidney transplantation Fluid therapy Creatinine Urea Urine |
topic |
Kidney transplantation Fluid therapy Creatinine Urea Urine |
description |
Abstract Purpose: Kidney transplantation is the gold-standard treatment for end stage renal disease. Although different hemodynamic variables, like central venous pressure and mean arterial pressure, have been used to guide volume replacement during surgery, the best strategy still ought to be determined. Respiratory arterial Pulse Pressure Variation (PPV) is recognized to be a good predictor of fluid responsiveness for perioperative hemodynamic optimization in operating room settings. The aim of this study was to investigate whether a PPV guided fluid management strategy is better than a liberal fluid strategy during kidney transplantation surgeries. Identification of differences in urine output in the first postoperative hour was the main objective of this study. Methods: We conducted a prospective, single blind, randomized controlled trial. We enrolled 40 patients who underwent kidney transplantation from deceased donors. Patients randomized in the “PPV” group received fluids whenever PPV was higher than 12%, patients in the “free fluid” group received fluids following our institutional standard care protocol for kidney transplantations (10 mL.kg-1. h-1). Results: Urinary output was similar at every time-point between the two groups, urea was statistically different from the third postoperative day with a peak at the fourth postoperative day and creatinine showed a similar trend, being statistically different from the second postoperative day. Urea, creatinine and urine output were not different at the hospital discharge. Conclusion: PPV guided fluid therapy during kidney transplantation significantly improves urea and creatinine levels in the first week after kidney transplantation surgery. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000300194 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000300194 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1016/j.bjane.2020.04.022 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Anestesiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Anestesiologia |
dc.source.none.fl_str_mv |
Revista Brasileira de Anestesiologia v.70 n.3 2020 reponame:Revista Brasileira de Anestesiologia (Online) instname:Sociedade Brasileira de Anestesiologia (SBA) instacron:SBA |
instname_str |
Sociedade Brasileira de Anestesiologia (SBA) |
instacron_str |
SBA |
institution |
SBA |
reponame_str |
Revista Brasileira de Anestesiologia (Online) |
collection |
Revista Brasileira de Anestesiologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Anestesiologia (Online) - Sociedade Brasileira de Anestesiologia (SBA) |
repository.mail.fl_str_mv |
||sba2000@openlink.com.br |
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1752126630596182016 |