Navigation Links
Results of the POSEIDON trial presented at TCT 2012
Date:10/25/2012

MIAMI, FL OCTOBER 25, 2012 A hydration regimen tailored to the patient's fluid status was effective in reducing damage to kidneys in patients undergoing cardiac catheterization, according to a study presented at the 24th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation. TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.

Contrast-induced acute kidney injury (CI-AKI), or contrast-induced nephropathy, refers to kidney damage that may occur due to the use of contrast dye that is necessary for visualization during catheterization and other procedures. Hydration remains the cornerstone for the prevention of kidney damage. However, there are no well-defined practical hydration protocols available for the prevention of CI-AKI. The Prevention of Contrast Renal Injury with Different Hydration Strategies (POSEIDON) trial investigated a novel sliding scale hydration protocol based upon routine invasively obtained left ventricular end-diastolic pressure measurements (LVEDP) in patients undergoing cardiac catheterization.

Patients undergoing coronary angiography with stable renal insufficiency (an estimated GFR <60 mL/min/1.73m2) and one additional CI-AKI risk factor were randomized 1:1 to an LVEDP guided hydration strategy or a standard hydration strategy.

Both groups received 0.9 percent saline at 3 mL/kg for at least one hour prior to cardiac catheterization. The LVEDP was measured in all patients at the start of the procedure and prior to contrast administration. In the LVEDP group, the fluid rate was adjusted according to the patients' LVEDP as follows: 5 mL/kg/hr for LVEDP <13 mmHg; 3 mL/kg/hr for 13-18 mmHg; 1.5 mL/kg/hr for >18 mmHg.

The standard hydration group was hydrated at 1.5 mL/kg/hr. The fluid rate was set at the start of the procedure (prior to contrast exposure), continued during the procedure, and for four hours post-procedure. The primary outcome, CI-AKI, was defined as a greater than 25 percent or greater than 0.5 mg/dl increase in serum creatinine an indicator of kidney damage up to four days post-procedure.

There were 396 patients randomized, 196 in the LVEDP group and 200 in the standard hydration group. Kidney damage was found in 6.7 percent of the LVEDP guided hydration group and in 16.3 percent of the standard hydration group (P = 0.005). There were no significant differences between groups for baseline renal function or LVEDP. The relative risk (95 percent confidence interval) for LVEDP-guided hydration versus standard hydration was 0.41 (0.22-0.79). The absolute risk difference was -9.5 percent in favor of LVEDP guided hydration; therefore, 11 patients would need to be treated to prevent one CI-AKI event.

"This is the first trial to test the hypothesis of a left ventricular end diastolic pressure-guided hydration strategy for prevention of contrast nephropathy. We found that this technique resulted in a significant 59 percent relative and 10 percent absolute reduction in contrast nephropathy," said lead researcher Somjot Brar, MD, MPH. Dr. Brar is an Interventional Cardiologist & Vascular Specialist at Kaiser Permanente in Los Angeles, CA and an Assistant Clinical Professor of Medicine at the University of California, Los Angeles.

"This is an easily implemented protocol that can be readily adapted in both inpatient and outpatient settings," Dr. Brar said.


'/>"/>
Contact: Judy Romero
jromero@crf.org
Cardiovascular Research Foundation
Source:Eurekalert

Related medicine news :

1. 1-year results of ADAPT-DES presented at TCT 2012
2. Comparison of Obesity Surgeries Turns Up Surprising Results
3. Results from study of Mead Johnsons Enfamil® Human Milk Fortifier Acidified Liquid published in Pediatrics
4. Missed Diagnoses in ICU Often Have Deadly Results: Review
5. Anti-clotting drugs yield similar results
6. Late-Night Cramming May Hurt School Test Results
7. New survey: Women want to SEE breast reconstruction results before cancer surgery
8. Weight-loss surgery results in positive changes in social life, medical conditions
9. Many Test Results Left Unread as Patients Leave Hospital: Study
10. 7-Day Stuttering Therapy May Get Results, Study Says
11. Swaziland HIV incidence results announced at AIDS 2012
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/21/2017)... ... July 21, 2017 , ... Hospital M&A activity slowed in the ... number of hospital acquisitions rose to 23 in the second quarter, up 15% from ... from the 20 announced deals in the year-ago second quarter. Only four of the ...
(Date:7/21/2017)... ... ... The House of Yahweh in Abilene, Texas, has written a new post this week that ... to be more open about positive changes. Yisrayl says the use of force is not ... positive way to solve all; yes, all issues, and he is ready to share this ...
(Date:7/21/2017)... ... July 21, 2017 , ... “Kids aren't born knowing ... tie their shoes,” says Suzanne Tucker, Founder of St. Louis-based positive education company Generation ... launches on Kickstarter on Monday, July 21st. , The kit uses colorful, engaging ...
(Date:7/21/2017)... TORONTO, ONTARIO, CANADA (PRWEB) , ... July 21, ... ... with over 80% follow-up at 10 years, researchers from the Multicenter Orthopaedics Outcome ... knee-related quality of life a decade after surgery, though activity levels decline over ...
(Date:7/20/2017)... ... July 20, 2017 , ... TransPixel Volume 2 is ... clips in the FCPX timeline. This effect isolates horizontal and vertical lines of pixels ... contains either a rotating or flipping animation and can be changed using a drop-down ...
Breaking Medicine News(10 mins):
(Date:7/5/2017)... , July 5, 2017 Oramed ... www.oramed.com ), a clinical-stage pharmaceutical company focused on ... it has received approval from the Israel Securities Authority to ... (TASE). Oramed common stock will commence trading on the TASE ... the current market capitalization of the Company, it is expected ...
(Date:7/1/2017)... WARSAW, Ind. , June 30, 2017 Zimmer ... second quarter sales and earnings conference call will be broadcast ... 8 a.m. Eastern Time.  A news release detailing the quarterly ... the morning of the conference call. The live ... website at http://investor.zimmerbiomet.com . It will be archived for ...
(Date:6/30/2017)... , June 29, 2017  Axium Pharmaceuticals Inc. is a pharmaceutical ... novel formulations and alternative dosage forms of existing biologically active ... ... on our waterless self-nano emulsifying formula, which is designed to ... We believe the spray will provide fast onset of action ...
Breaking Medicine Technology: