Prevention of rhabdomyolysis-induced acute kidney injury - A DASAIM/DSIT clinical practice guideline.
Acta Anaesthesiologica Scandinavica · 2019-01-15 · Guideline / consensus
Abstract
BACKGROUND: Rhabdomyolysis-induced acute kidney injury (AKI) is a common and serious condition. We aimed to summarise the available evidence on this topic and provide recommendations according to current standards for trustworthy guidelines. METHODS: This guideline was developed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The following preventive interventions were assessed: (a) fluids, (b) diuretics, (c) alkalinisation, (d) antioxidants, and (e) renal replacement therapy. Exclusively patient-important outcomes were assessed. RESULTS: We suggest using early rather than late fluid resuscitation (weak recommendation, very low quality of evidence). We suggest using crystalloids rather than colloids (weak recommendation, low quality of evidence). We suggest against routine use of loop diuretics as compared to none (weak recommendation, very low quality of evidence). We suggest against use of mannitol as compared to none (weak recommendation, very low quality of evidence). We suggest against routine use of any diuretic as compared to none (weak recommendation, very low quality of evidence). We suggest against routine use of alkalinisation with sodium bicarbonate as compared to none (weak recommendation, low quality of evidence). We suggest against the routine use of any alkalinisation as compared to none (weak recommendation, low quality of evidence). We suggest against routine use of renal replacement therapy as compared to none (weak recommendation, low quality of evidence). For the remaining PICO questions, no recommendations were issued. CONCLUSION: The quantity and quality of evidence supporting preventive interventions for rhabdomyolysis-induced AKI is low/very low. We were able to issue eight weak recommendations and no strong recommendations.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Crystalloids · Fluids & blood · Other drugs · Sodium bicarbonate
Related articles
- Management of rhabdomyolysis: A practice management guideline from the Eastern Association for the Surgery of Trauma. (Am J Surg, 2022)
- Treatment of exertional rhabdomyolysis in athletes: a systematic review. (JBI Database System Rev Implement Rep, 2016)
- Observation on the effectiveness and safety of sodium bicarbonate Ringer's solution in the early resuscitation of traumatic hemorrhagic shock: a clinical single-center prospective randomized controlled trial. (Trials, 2022)
- Descriptive Analysis of Intratheater Critical Care Air Transport Team Patient Movements During Troop Drawdown: Afghanistan (2017-2019). (Mil Med, 2023)
- Clinical study of sodium bicarbonated Ringer's solution on fluid resuscitation of patients with hemorrhagic shock. (Eur Rev Med Pharmacol Sci, 2022)
- An evaluation of the outside therapy of diabetic ketoacidosis in pediatric patients. (Am J Ther, 2008)