tailieunhanh - Báo cáo y học: " Intensity of renal replacement therapy in acute kidney injury: perspective from within the Acute Renal Failure Trial Network Study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Intensity of renal replacement therapy in acute kidney injury: perspective from within the Acute Renal Failure Trial Network Study. | Available online http content 13 4 310 Viewpoint Intensity of renal replacement therapy in acute kidney injury perspective from within the Acute Renal Failure Trial Network Study Paul M Palevsky1 2 Theresa Z O Connor3 Glenn M Chertow4 Susan T Crowley3 5 Jane Hongyuan Zhang3 and John A Kellum2 for the US Department of Veterans Affairs National Institutes of Health Acute Renal Failure Trial Network 1 Room 7E123 111F-U VA Pittsburgh Healthcare System University Drive Pittsburgh PA 15240 USA 2University of Pittsburgh School of Medicine Pittsburgh PA 15261 USA 3VA Connecticut Healthcare System 950 Campbell Avenue West Haven CT 06516 USA 4Stanford University School of Medicine Palo Alto CA 94305 USA 5Yale University School of Medicine New Haven CT 06520 USA Corresponding author Paul M Palevsky Palevsky@ Published 11 August 2009 This article is online at http content 13 4 310 2009 BioMed Central Ltd Critical Care 2009 13 310 doi cc7901 Abstract Determination of the optimal dose of renal replacement therapy in critically ill patients with acute kidney injury has been controversial. Questions have recently been raised regarding the design and execution of the US Department of Veterans Affairs National Institutes of Health Acute Renal Failure Trial Network ATN Study which demonstrated no improvement in 60-day all-cause mortality with more intensive management of renal replacement therapy. In the present article we present our rationale for these aspects of the design and conduct of the study including our use of both intermittent and continuous modalities of renal support our approach to initiation of study therapy and the volume management during study therapy. In addition the article presents data on hypotension during therapy and recovery of kidney function in the perspective of other studies of renal support in acute kidney injury. Finally we address the implications of the ATN Study results for clinical practice from the .

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