Department of Internal Medicine, School of Medicine and Hospital das Clínicas-Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil.
Hospital das Clínicas: Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
J Ultrasound. 2023 Jun;26(2):449-457. doi: 10.1007/s40477-022-00730-y. Epub 2022 Dec 2.
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.
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.
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.
The use of bedside US in the immediate postoperative period of high-risk surgery did not show benefits in reducing AKI incidence.
本研究旨在确定在高危手术患者的术后即刻期（POP）进行床边超声检查是否会影响急性肾损伤（AKI）的发生。
将 POP 患者随机分为两组：（i）超声（US）组，其血流动力学管理以临床参数为指导，并辅以床边 US 检查结果；（ii）对照组，血流动力学管理仅基于临床参数。在入院后的前 24 小时内进行了两次检查。
51 例患者被随机分配至 US 组，60 例患者被分配至对照组。两组在术后 12 小时（31.4%比 35.0%，P=0.84）、24 小时（27.5%比 23.3%，P=0.66）和 7 天（17.6%比 8.3%，P=0.16）时 AKI 的发生率均无显著差异。在第一个 12 小时内（1000[500-2000]比 1000[500-1500]，P=0.72）和 24 小时内（1000[0-1500]比 1000[0-1500]，P=0.95），两组之间接受的液体量也没有差异。在对照组中未发生 AKI 的患者在 ICU 期间接受了更高的液体量。
在高危手术的术后即刻期使用床边超声并不能显示出降低 AKI 发生率的益处。
