Henrique Palomba1, Pedro Paulo Zanella do Amaral Campos2, Thiago Domingos Corrêa3, Frederico Bruzzi de Carvalho4, Glauco Westphal5, Dimitri Gusmão6, Thiago Lisboa7, Cintia Magalhães Carvalho Grion8, Murillo Santucci Cesar de Assunção9. 1. Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: henrique.palomba@einstein.br. 2. Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: pedro.zanella@einstein.br. 3. Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: thiago.correa@einstein.br. 4. Hospital Eduardo de Menezes, Fundação Hospitalar de Minas Gerais, Belo Horizonte, Brazil. Electronic address: fredbruzcarv@gmail.com. 5. Intensive Care Unit, Centro Hospitalar Unimed, Joinville, Brazil. Electronic address: glauco.w@brturbo.com.br. 6. Hospital Geral Roberto Santos, Hospital Universitário Professor Edgars Santos, Salvador, Brazil. Electronic address: dimitrigusmao@gmail.com. 7. Hospital de Clinicas/Hospital Santa Rita-Complexo Hospitalar Santa Casa-Porto Alegre, Porto Alegre, Brazil. Electronic address: tlisboa@hotmail.com. 8. Hospital Evangélico de Londrina, Hospital Universitário Regional do Norte do Paraná, Londrina, Brazil. Electronic address: cintiagrion@sercomtel.com.br. 9. Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: murillo.assuncao@einstein.br.
Abstract
PURPOSE: The purpose of the study is to characterize the practices of Brazilian intensivists toward acute kidney injury (AKI) definition and management. METHODS: A cross-sectional survey was conducted among 36 Brazilian hospitals. RESULTS: Of 731 ICU physicians invited to participate, 310 (42%) responded to the survey. Nearly half of the intensive care unit (ICU) physicians (146/310) do not apply AKIN and/or RIFLE definitions to their ICU patients. Most of the respondents prescribe intravenous fluids as a first-line therapeutic intervention for AKI patients. Although 38% of the surveyed physicians considered worsening of respiratory parameters to be the main criterion for stopping fluid infusion, only 15% considered daily net fluid balance as a criterion. Most of the respondents believed in the benefits of early renal replacement therapy (RRT) and considered worsening acidosis the most important criteria for starting early RRT. The main reason for a nephrologist referral was an urgently needed RRT. CONCLUSIONS: Despite recent advances in AKI definition and management, most of the surveyed ICU physicians in Brazil have not incorporated them in their clinical practice. Important differences in the management of AKI patients were observed among Brazilian ICU physicians, which is relevant for educational interventions and future research.
PURPOSE: The purpose of the study is to characterize the practices of Brazilian intensivists toward acute kidney injury (AKI) definition and management. METHODS: A cross-sectional survey was conducted among 36 Brazilian hospitals. RESULTS: Of 731 ICU physicians invited to participate, 310 (42%) responded to the survey. Nearly half of the intensive care unit (ICU) physicians (146/310) do not apply AKIN and/or RIFLE definitions to their ICU patients. Most of the respondents prescribe intravenous fluids as a first-line therapeutic intervention for AKI patients. Although 38% of the surveyed physicians considered worsening of respiratory parameters to be the main criterion for stopping fluid infusion, only 15% considered daily net fluid balance as a criterion. Most of the respondents believed in the benefits of early renal replacement therapy (RRT) and considered worsening acidosis the most important criteria for starting early RRT. The main reason for a nephrologist referral was an urgently needed RRT. CONCLUSIONS: Despite recent advances in AKI definition and management, most of the surveyed ICU physicians in Brazil have not incorporated them in their clinical practice. Important differences in the management of AKI patients were observed among Brazilian ICU physicians, which is relevant for educational interventions and future research.
Authors: Raúl Lombardi; Alejandro Ferreiro; Rolando Claure-Del Granado; Emmanuel A Burdmann; Guillermo Rosa-Diez; Luis Yu; Mauricio Younes-Ibrahim; Cristina Carlino; Jonathan S Chávez-Iñiguez; Mariana B Pereira; Carlos F Varela; Welder Zamoner; Diego Janiques; Soledad Lecueder; Víctor Cerrón-Millán; Alfonso Cueto-Manzano Journal: PLoS One Date: 2019-11-14 Impact factor: 3.240
Authors: Pedro Paulo Zanella do Amaral Campos; Guilherme Martins de Souza; Thais Midega; Hélio Penna Guimarães; Thiago Domingos Corrêa; Ricardo Luiz Cordioli Journal: Rev Bras Ter Intensiva Date: 2022 Jan-Mar
Authors: Reginaldo Passoni Dos Santos; Ariana Rodrigues da Silva Carvalho; Luis Alberto Batista Peres Journal: Sci Rep Date: 2019-12-02 Impact factor: 4.379