Acute Kidney Injury, Anemia, Fluid Overload, Transfusion-Associated Circulatory Overload
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. It is associated with the occurrence of acute kidney injury (AKI). Many parameters have been described as influential on the values of renal RI. Red blood cell (RBC) transfusion were shown to be able to increase renal oxygenation in animal model, whereas crystalloid resuscitation did not. We sought to describe the different effect of crystalloids infusion and RBC transfusion on renal blood flow, as evaluated with doppler ultrasound
Interventions
OTHERTransfusion
RBC transfusion (1 unit)
OTHERCrystalloids infusion
Infusion of 500 ml of balanced crystalloids
Sponsors
Università degli Studi di Ferrara
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Age \> 18 and \< 90 * Hemoglobin ≥7 and ≤ 10 g/dl
Exclusion criteria
* Ultrasound RRI evaluation non available * Patients with arrhythmia * Pregnancy * Refusal to give consent * History of renal transplantation * Central venous access in superior vena cava not available Critical active bleeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in renal resistivity index (RRI) after intervention | after 60 minute from intervention | To compare change in RRI after intervention between groups. Values over\>0.70 are considered pathological. Higher values means worse outcome. |
| Change Renal Venous Stasis Index (RSVI) after intervention | after 60 minute from intervention | To compare change in RSVI after intervention between groups. Under physiological conditions, the index is zero. Higher values means worse outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Variation in Renal Venous Stasis Index (RSVI) | after 24 hours from intervention | To compare change in RSVI after intervention between groups. Under physiological conditions, the index is zero. Higher values means worse outcome. |
| Variation in renal resistivity index (RRI) | after 24 hours from intervention | To compare change in RRI after intervention between groupsValues over\>0.70 are considered pathological. Higher values means worse outcome. |
| Occurence of AKI | Once a day for 7 days | Occurence of AKI as defined by Kidney Disease: Improving Global Outcomes (KDIGO) |
Other
| Measure | Time frame | Description |
|---|---|---|
| correlation between arterial-venous oxygen differences and changes in renal resistivity index (RRI) after intervention | after 24 hours from intervention | RRI values over\>0.70 are considered pathological. Higher values means worse outcome. |
| correlation between arterial-venous oxygen differences and changes in Renal Venous Stasis Index (RSVI) | after 24 hours from intervention | Under physiological conditions, the index is zero. Higher values means worse outcome. |
Countries
Italy
Outcome results
None listed