Acute Kidney Injury, Respiration, Artificial, Respiratory Distress Syndrome, Adult
Conditions
Brief summary
The renal Doppler resistive index (RRI) is a noninvasive tool that has been used to assess renal perfusion in the intensive care unit (ICU) setting. Many parameters have been described as influential on the values of renal RI. Mechanical ventilation is associated with significant increases in the risk of acute kidney injury (AKI). Ventilator-induced kidney injury (VIKI) is believed to occur due to changes in hemodynamics that impair renal perfusion. The investigators hypothesized that patients who need mechanical ventilation should have a different response in RRI when different levels of Positive end expiratory pressure (PEEP) are applied. Investigators wish to describe changing in RRI due to changes in PEEP and to verify whether these changes could partially explain the occurrence of VIKI
Interventions
PROCEDUREPEEP changes
All patients will be ventilated with a tidal volume of 6 ml/kg before the RRI assessment. Further, three level of PEEP (5, 10 and 15 cmH2O) will be randomly set. For each levels of PEEP, the RRI will be evaluated
Sponsors
Università degli Studi di Ferrara
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients admitted to ICU with expected mechanical ventilation \>48h
Exclusion criteria
* Ultrasound RRI evaluation non available * Patients with arrhythmia * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Occurence of AKI | once a day until day 7 | AKI will be defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in RRI at different level of PEEP | One a day until day 5 | To compare median difference of RRI at PEEP 5 and PEEP 15 in patients who will develop (or not) AKI |
Countries
Italy
Outcome results
None listed