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10.1186/s13054-015-0906-9 http://scihub22266oqcxt.onion/10.1186/s13054-015-0906-9 C4470026!4470026 !25899029     free     free     free Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\25899029 .jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117       Crit+Care 2015 ; 19 (1 ): 183 Nephropedia Template TP {{tp|p=25899029 |t=2015. Does sodium bicarbonate infusion really have no effect on the incidence of acute kidney injury after cardiac surgery? A prospective observational trial |pdf=|usr=}}{{25899029 }} gab.com Text Does sodium bicarbonate infusion really have no effect on the incidence of acute kidney injury after cardiac surgery A prospective observational trial JO: Crit Care http://www.kidney.de/pget.php?&tw=1&pmid=25899029 #FOAvip INTRODUCTION: Postoperative acute kidney injury (AKI) is a frequently observed phenomenon after cardiac surgery with cardio-pulmonary bypass (CPB); this severe complication is associated with adverse patient outcomes. There are multiple mechanisms involved in AKI during cardiac surgery, including CPB-dependent hemolysis. An IV infusion of sodium bicarbonate, which leads to urine alkalization, may play a role in preventing AKI. Recently, several trials have investigated the effect of sodium bicarbonate and reported controversial results. The purpose of this investigation was to investigate the following question. Under what circumstances can sodium bicarbonate prevent postoperative AKI? METHODS: We analyzed data from 342 patients undergoing CPB surgery at the University Hospital Goettingen, Germany. A total of 174 patients received a preemptive dose of sodium bicarbonate. Directly after the induction of anesthesia, the continuous infusion of 0.15 mmol/kg body weight/h was started and continued until 2 pm on the first postoperative day. Patients who were not treated with sodium bicarbonate formed the control group (n?=?168). To verify the AKI risk configuration of each group, we surveyed risk factors and determined the commonly used clinical predictive score according to Thakar and colleagues. We recorded the concentration of free hemoglobin (fhb) to estimate the amount of CPB-dependent hemolysis. The definition of AKI was acquired by applying the AKI-network (AKIN) classification over the course of five postoperative days. RESULTS: Patients who received the sodium bicarbonate infusion showed a significantly lower incidence (35.6 vs. 50%) of AKI than that of patients who did not receive the infusion (p?=?0.01). AKIN levels 2 and 3 were also more frequent when sodium bicarbonate was not administered. Particularly, in the low-risk cohort (<3 Thakar points), the incidence of AKI was significantly reduced (26 vs. 46%) when patients received sodium bicarbonate (p?=?0.01), whereas in the high-risk patients, no significant reduction was observed. CONCLUSION: In this study, we observed that low-risk patients particularly benefited from the preventive treatment with sodium bicarbonate. The incidence of AKI was significantly reduced in low-risk patients while there was no statistically significant difference in the high-risk patient cohort. TRIAL REGISTRATION: DRKS00007616, Registered 12 December 2014. Twit Text FOAVip Does sodium bicarbonate infusion really have no effect on the incidence of acute kidney injury after cardiac surgery A prospective observational trial ????Crit Care http://www.kidney.de/pget.php?&tw=1&pmid=25899029 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25899029 #FOAvip English Wikipedia <ref>{{Cite pmid|25899029 }}</ref> Does sodium bicarbonate infusion really have no effect on the incidence of acute kidney injury after cardiac surgery? A prospective observational trial #MMPMID25899029 Wetz AJ ; Bräuer A ; Quintel M ; Heise D Crit Care 2015[Apr]; 19 (1 ): 183 PMID25899029 show ga INTRODUCTION: Postoperative acute kidney injury (AKI) is a frequently observed phenomenon after cardiac surgery with cardio-pulmonary bypass (CPB); this severe complication is associated with adverse patient outcomes. There are multiple mechanisms involved in AKI during cardiac surgery, including CPB-dependent hemolysis. An IV infusion of sodium bicarbonate, which leads to urine alkalization, may play a role in preventing AKI. Recently, several trials have investigated the effect of sodium bicarbonate and reported controversial results. The purpose of this investigation was to investigate the following question. Under what circumstances can sodium bicarbonate prevent postoperative AKI? METHODS: We analyzed data from 342 patients undergoing CPB surgery at the University Hospital Goettingen, Germany. A total of 174 patients received a preemptive dose of sodium bicarbonate. Directly after the induction of anesthesia, the continuous infusion of 0.15 mmol/kg body weight/h was started and continued until 2 pm on the first postoperative day. Patients who were not treated with sodium bicarbonate formed the control group (n?=?168). To verify the AKI risk configuration of each group, we surveyed risk factors and determined the commonly used clinical predictive score according to Thakar and colleagues. We recorded the concentration of free hemoglobin (fhb) to estimate the amount of CPB-dependent hemolysis. The definition of AKI was acquired by applying the AKI-network (AKIN) classification over the course of five postoperative days. RESULTS: Patients who received the sodium bicarbonate infusion showed a significantly lower incidence (35.6 vs. 50%) of AKI than that of patients who did not receive the infusion (p?=?0.01). AKIN levels 2 and 3 were also more frequent when sodium bicarbonate was not administered. Particularly, in the low-risk cohort (<3 Thakar points), the incidence of AKI was significantly reduced (26 vs. 46%) when patients received sodium bicarbonate (p?=?0.01), whereas in the high-risk patients, no significant reduction was observed. CONCLUSION: In this study, we observed that low-risk patients particularly benefited from the preventive treatment with sodium bicarbonate. The incidence of AKI was significantly reduced in low-risk patients while there was no statistically significant difference in the high-risk patient cohort. TRIAL REGISTRATION: DRKS00007616, Registered 12 December 2014. |Acute Kidney Injury/etiology/*prevention & control [MESH] |Aged [MESH] |Cardiopulmonary Bypass [MESH] |Cardiovascular Surgical Procedures/*adverse effects [MESH] |Female [MESH] |Humans [MESH] |Incidence [MESH] |Infusions, Intravenous [MESH] |Male [MESH] |Prospective Studies [MESH] |Risk Assessment [MESH]Does sodium bicarbonate infusion really have no effect on the incidenc(epmc).pdf DeepDyve Pubget Overpricing