tailieunhanh - Báo cáo y học: "Bench-to-bedside review: Preventive measures for contrast-induced nephropathy in critically ill patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Bench-to-bedside review: Preventive measures for contrast-induced nephropathy in critically ill patients. | Available online http content 9 4 361 Review Bench-to-bedside review Preventive measures for contrast-induced nephropathy in critically ill patients Guido van den Berk1 Sanne Tonino1 Carola de Fijter2 Watske Smit3 and Marcus J Schultz4 1 Resident Department of Internal Medicine Onze Lieve Vrouwe Gasthuis Amsterdam The Netherlands 2Internist Department of Nephrology Onze Lieve Vrouwe Gasthuis Amsterdam The Netherlands 3Internist Department of Nephrology Academic Medical Center University of Amsterdam Amsterdam The Netherlands 4Internist Department of Intensive Care Medicine Academic Medical Center University of Amsterdam Amsterdam The Netherlands Corresponding author Guido van den Berk guidovdberk@ Published online 7 January 2005 This article is online at http content 9 4 361 2005 BioMed Central Ltd Critical Care 2005 9 361-370 DOI cc3028 Abstract An increasing number of diagnostic imaging procedures requires the use of intravenous radiographic contrast agents which has led to a parallel increase in the incidence of contrast-induced nephropathy. Risk factors for development of contrast-induced nephropathy include pre-existing renal dysfunction especially diabetic nephropathy and multiple myeloma-associated nephropathy dehydration congestive heart failure and use of concurrent nephrotoxic medication including aminoglycosides and amphotericin B . Because contrast-induced nephropathy accounts for a significant increase in hospital-acquired renal failure several strategies to prevent contrast-induced nephropathy are currently advocated including use of alternative imaging techniques for which contrast media are not needed use of the lowest possible amount of iso-osmolar or low-osmolar contrast agents instead of high-osmolar contrast agents hyperhydration and forced diuresis. Administration of N-acetylcysteine theophylline or fenoldopam sodium bicarbonate infusion and periprocedural haemofiltration haemo-dialysis have been .