Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Jun;26(2):449-457.
doi: 10.1007/s40477-022-00730-y. Epub 2022 Dec 2.

Impact of bedside ultrasound to reduce the incidence of acute renal injury in high-risk surgical patients: a randomized clinical trial

Cecilia Gómez Ravetti  1 , Paula Frizera Vassallo  2 , Thiago Bragança Lana Silveira Ataíde  2   3 , Renan Detoffol Bragança  2   3 , Augusto Cesar Soares Dos Santos Jr  2   3 , Fabrício de Lima Bastos  4 , Guilherme Carvalho Rocha  4 , Mateus Rocha Muniz  4 , Isabela Nascimento Borges  4   3 , Carolina Coimbra Marinho  4 , Vandack Nobre  5 ; NIIMI—Núcleo Interdisciplinar de Investigação em Medicina Intensiva
Affiliations
Randomized Controlled Trial

Impact of bedside ultrasound to reduce the incidence of acute renal injury in high-risk surgical patients: a randomized clinical trial

Cecilia Gómez Ravetti et al. J Ultrasound. 2023 Jun.

Abstract

Purpose: This study aimed to determine whether performing bedside ultrasound impacts the occurrence of acute kidney injury (AKI) in the immediate postoperative period (POP) of high-risk surgery patients.

Methods: POP patients were randomly assigned to two groups: (i) ultrasound (US) group, in which hemodynamic management was guided with clinical parameters supplemented with the bedside US findings; (ii) control group, hemodynamic management based solely on clinical parameters. Two exams were performed in the first 24 h of admission.

Results: Fifty-one patients were randomized to the US group and 60 to the control group. There was no significant difference for incidence of AKI in both groups assessed 12 h (31.4% vs 35.0%, P = 0.84), 24 h (27.5% vs 23.3%, P = 0.66), or 7 days (17.6 vs 8.3%, P = 0.16) after surgery. No difference was found in the amounts of volume administered over the first 12 h (1000 [500-2000] vs. 1000 [500-1500], P = 0.72) and 24 h (1000 [0-1500] vs. 1000 [0-1500], P = 0.95) between the groups. Patients without AKI in the control group received higher amounts of volume during the ICU stay.

Conclusion: The use of bedside US in the immediate postoperative period of high-risk surgery did not show benefits in reducing AKI incidence.

Keywords: Acute kidney injury; Intensive care unit; Postoperative period; Ultrasound.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interests.

Figures

Fig. 1
Fig. 1
Decision making flowchart in the ultrasound group
Fig. 2
Fig. 2
Flowchart of eligible patients. CRD chronic renal disease, ICF informed consent form
Fig. 3
Fig. 3
KDIGO score and mortality in ICU
See this image and copyright information in PMC

References

    1. Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe-Leitz T, et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet. 2015;385(Suppl 2):S11. doi: 10.1016/S0140-6736(15)60806-6. - DOI - PubMed
    1. Jämsä P, Jämsen E, Lyytikäinen LP, Kalliovalkama J, Eskelinen A, Oksala N. Risk factors associated with acute kidney injury in a cohort of 20,575 arthroplasty patients. Acta Orthop. 2017;88(4):370–376. doi: 10.1080/17453674.2017.1301743. - DOI - PMC - PubMed
    1. Gameiro J, Neves JB, Rodrigues N, Bekerman C, Melo MJ, Pereira M, et al. Acute kidney injury, long-term renal function and mortality in patients undergoing major abdominal surgery: a cohort analysis. Clin Kidney J. 2016;9(2):192–200. doi: 10.1093/ckj/sfv144. - DOI - PMC - PubMed
    1. Ozrazgat-Baslanti T, Thottakkara P, Huber M, Berg K, Gravenstein N, Tighe P, et al. Acute and chronic kidney disease and cardiovascular mortality after major surgery. Ann Surg. 2016;264(6):987–996. doi: 10.1097/SLA.0000000000001582. - DOI - PMC - PubMed
    1. Turan A, Cohen B, Adegboye J, Makarova N, Liu L, Mascha EJ, et al. Mild acute kidney injury after noncardiac surgery is associated with long-term renal dysfunction: a retrospective cohort study. Anesthesiology. 2020. - PubMed

Publication types

LinkOut - more resources