Acute Kidney Injury
Conditions
Brief summary
1. Evaluate Inferior Vena Cava Indices (Diameters , IVC-CI)&carotid doppler measurements (corrected Carotid Flow Time ,Carotid Blood Flow ,Carotid Artery Peak Velocity Variations) as Non-Invasive Technique for volume guided management in AKI Patient. 2. Estimate correlation between IVC (Diameters , IVC-CI) & carotid doppler measurements (corrected Carotid Flow Time ,Carotid Blood Flow ,Carotid Artery Peak Velocity Variations) as Non-Invasive Technique for volume guided management in AKI Patient.
Detailed description
Acute kidney injury affects increasing numbers of patients worldwide, it was estimated approximately 15% of all subjects treated in hospitals develop Acute kidney injury,even a small increase in serum creatinine may be associated with increased risk of mortality , Oliguric AKI it imposes a great challenge for fluid management. Recently, ultrasonography for estimating volume status has been widely recommended because of its non-invasive nature, ease of acquisition, and reproducibility of measurements.Among these ultrasound modalities, ultrasonographic assessment of the inferior vena cava & Carotid doppler measurements . In spontaneously breathing patients, the inferior vena cava (IVC) diameter and the IVC Collapsibility Index (IVC-CI) have been shown to correlate with the volume status and central venous pressure (CVP) . also has been shown to indicate fluid status in children , ventilated patients and healthy volunteers . corrected Carotid Flow Time (CFT) unaffected by respiration predicting fluid responsiveness that has shown promising results.Studies to date have shown that corrected CFT increases in response to fluid administration or consumption , and decreases in response to volume removal in dialysis and blood donation .
Interventions
DEVICEIVC ultrasound & Carotid doppler
bed side ultrasonographic assessement of inferior vena cava maximum and minimum diameters 2 to 5 cm caudal to its junction with the right atrium over a single respiratory cycle , inferior vena cava collapsibility index (IVC-CI) will calculated as (IVC max - IVC min)/IVC max). carotid doppler assessment (2-3 cm proximal to the carotid bulb in the longitudinal plane) of corrected carotid flow time(systole time/√cycle time) ,carotid artery peak velocity variation calculated as (\[PV max- PV min\]/PV mean) × 100, where PV mean = (PV max + PV min)/2. during three consecutive respiratory cycles. as part of their routine care and assessment
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
1. Patients diagnosed with Acute Kidney Injury 2. age must be more than 18 years
Exclusion criteria
1. Morbid obesity (BMI \>35) 2. End Stage Renal Disease (ESRD) on dialysis 3. Sever ventricular dysfunction, valvular heart disease 4. Carotid stenosis \>50% 5. chronic obstructive pulmonary disease. 6. Pregnancy & tense ascites
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| percentage of participants with improved serum creatinine level in µmol/L in groups A and B. | at 48 hours | percentage of participants with improved serum creatinine level in µmol/L in groups A and B. |
| percentage of participants with improved urine out put in ml/kg/h in groups A and B. | at 48 hours | percentage of participants with improved urine out put in ml/kg/h in groups A and B. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| percentage of participants with improved mean arterial blood pressure in mmHg in groups A and B. | at 48 hours | percentage of participants with improved mean arterial blood pressure in mmHg in groups A and B. |
Contacts
Primary ContactAyman Mohamed, dectorate
Outcome results
None listed