INTRAVENOUS CONTRAST AGENTS:

AN INTENSIVISTS PERSPECTIVE
Conf. Dr. Dana TOMESCU
U.M.F. ”Carol Davila” Bucharest
Fundeni Clinical Institute
Why should be have an intensivist in
the Radiology department?
Contrast induced AKI Anaphylactic reactions

Sedation Shock and

Cardiac arrest

Specific populations Needle phobia

A WIN–WIN scenario
• Radiologists are needed in the ICU as part of:
▫ Multidisciplinary team
▫ Rapid diagnosis of acute critical illness
▫ Bedside assessment
▫ Provide state of the art care for OUR patients
Anaphilaxis ... A common enemy
Severity of Allergic reactions
• 220 pts. with Skin prick, intradermal and patch
tests with a series of contrast media.
Risk reduction
• In patients with at least one risk factor able to
take oral medication
▫ Prednisone 50mg p.o. 13, 7 and 1 hour before
the examination and antiH1 p.o. 1 hour before
examination
OR
▫ Metylprednisolone 32 mg p.o. 12 and 2 hours
before examination +/- antiH1 p.o. 1 hour before
examination
Risk reduction
• In patients with at least one risk factor unable to
take oral medication
▫ Metylprednisolone 40 mg i.v. or Hydrocortisone
200 mg i.v. every 4 hours before the
examination and antiH1 p.o. 1 hour before the
examination
Be prepared!
• Use radiocontrast media only when clinically
indicated
• Perform the examination during normal
working hours except for emergency
situation!
• Inform the ICU team to be on stand-by
• Be prepared for the worst scenario!
Must have at all times
• Oxygen source and appropriate equipment
(facemask, oxygen delivery system etc)
• Monitoring system (in accordance with
national and international standards): EKG, HR,
SpO2, NIBP
• Airway management:
▫ Intubation set (for both adults and children)
▫ Laringoscope (MRI compatible !)
▫ Laringeal mask
▫ Emergency traheostomy
Must have at all times
• Vascular access (peripheral venous catheter)
• Defibrilator
• Emergency drugs:
▫ Adrenaline (1 mg/ml, 0.1 mg/ml, 0.01 mg/ml)
▫ Atropine
▫ Corticosteroids i.v.
▫ Cristaloids
And if it happens…
• Grade I = pruritus, generalized eritema,
angioedema
▫ Pruritus – anti-H1 per os: desloratadine (Aerius)
5 mg, clemastine (Tavegyl) 1 mg, loratadine
(Claritine) 10 mg;

▫ Angioedema – corticoids: Hydrocortisone 200

mg i.v. administered over 2 min or
metylprednisolone 40 mg iv administered over 2
min
And if it happens…
• Grade II: grade I + arterial hypotension, sinus
tachicardia, respiratory failure:
▫ Call for HELP (ICU, ED, 911)
▫ Administer Oxygen (6-10 l/min)
▫ Place the patient in Trendelemburg position
▫ Fluid resuscitation (cristaloids)
▫ Normal BP: adrenaline 0.1-0.3 mg i.m. in adults
▫ Hypotension: adrenaline 0.5 mg i.m in adults
And if it happens…
• Grade III: cardiovascular colapse + severe
bronhospasm:
▫ Call for HELP (ICU, ED, 911)
▫ Administer Oxygen (6-10 l/min)
▫ Place the patient in Trendelemburg position
▫ Fluid resuscitation (cristaloids): 30-50 ml/kg
▫ Adrenaline 0.1-0.2 mg i.v. q 2 min
▫ If severe bradycardia: atropine 0.6-1 mg i.v.
repeated every 3 minutes (maximal dose 3 mg)
And if it happens…
• Grade IV – cardiorespiratory arrest

https://cprguidelines.eu

All downloads
Videos
Download guidelines

ERC Guidelines 2015 have arrived!

Sedation in radiology department
• Who can benefit the most?
Sedation in radiology department
• Who can benefit the most?
▫ children
Sedation in radiology department
• Who can benefit the most?
▫ Children
▫ Interventional radiology
American Society of Anaesthesiology
standards

Standard I
▫ Qualified anesthesia personnel shall be present in the
room throughout the conduct of all GA, RA, MAC

Standard II
▫ During all anesthetics, the patient’s respiratory
(ventilation, oxygenation), circulation and temperature
shall be continually evaluated
Sedation for interventional radiology
Sedation for interventional radiology
Sedation in radiology department
• Who can benefit the most?
▫ Children
▫ Interventional radiology
▫ Needle phobia
▫ Claustrophobia (incidence 12:1000)
Sedation in radiology department
• Who can benefit the most?

• What to do?
Sedation in radiology department
• Who can benefit the most?

• What to do?
▫ Communicate to your patient and attending
physician
▫ Timming: Perform the procedure during normal
working hours (anesthetist on demand)
▫ Weight the risk – benefits of procedure vs.
anaesthesia
Acute Kidney Injury
• A rationalist perspective:
▫ CI AKI must be viewed in terms of risk-benefit

▫ Current approaches to prevention must use

existing evidence

▫ Prevention is likely not a single intervention

▫ Multidisciplinary approach: intensivist,

nephrologist, radiologist …
Prevention of Contrast-Associated Acute
Kidney Injury: What Should We Do?

• There were no differences in risk for contrast-associated

AKI associated with different types of low-osmolal
contrast media
Prevention of Contrast-Associated Acute
Kidney Injury: What Should We Do?
Prevention of Contrast-Associated Acute
Kidney Injury: What Should We Do?

• Acetylcysteine does not reduce the risk of

contrast-induced acute kidney injury
Prevention of Contrast-Associated Acute
Kidney Injury: What Should We Do?

• Intravenous sodium bicarbonate as compared to

intravenous saline was not associated with a
reduction in risk for contrast-associated AKI
NO really effective prevention
therapy but…

”RENALISM”
the fear of renal failure

•
NO really effective prevention
therapy but…
• We do not really know that much about CI
AKI outside cardiac catheterization

• We probably undertreat high risk

patients because of fear of AKI
 American Journal of

Nephrolo Am J Nephrol 2010;32:497–504 Received: July 18, 2010

Accepted: September 20, 2010
DOI: 10.1159/000321344
Published online: October 26, 2010

Renal Replacement Therapy for Prevention of

Contrast-Induced Acute Kidney Injury: In-Depth Topic Review
A Meta-Analysis
Table 1. Characteristics ofof Randomized
included trials Controlled Trials
Nephrolo
American Journal of

Am J Nephrol 2010;32:497–504 Re
Ac
First author Country Publica- Pa- Age Baseline mean serum creatinine, mg/dl DOI: 10.1159/000321344
Contrast agent Pu
Kai SongTableShan Jiang Yongbing Shi tion year Huaying Shen
1. Characteristics of included trials
tients years Xiaosong Shi
control group HD group CKD stage
Donghua Jing
Lehnert
First [10]
author Germany
Country 1998
Publica- Pa-30 60.1
Age B2.58
aseline mean 2.26 3 mg/dl
serum creatinine, iopentol agent
Contrast
Sterner
Department [11]
of Nephrology, SwedenAffiliatedtion
Second 2000 32
year oftients
Hospital 65–72
University, 2.62–3.43
years
Soochow Suzhou, China3.36–3.86 3 iohexol/iodixanol/ioxaglate
control group HD group CKD stage
Berger [12] Germany 2001 15 62–70 2.9 2.5 3 iopromide
Vogt [13]
Lehnert [10]
Frank [14]
Switzerland
Germany
Germany
2001
1998
2003
133
30
17
69–70
60.1 Renal Replacement Therapy for Prevention of
3.58
57.6–66.8 2.58
4.2
3.48
2.26
3.9
3
33
nonionic, low osmolality
iopentol
iomeprol
Sterner
Marenzi[11] Sweden 2000 32 65–72 2.62–3.43 3.36–3.86 34 iohexol/iodixanol/ioxaglate
Berger
Marenzi
Vogt [13]
[15]
[12]
[16]
Italy
Germany
Italy
Switzerland
2003
2001
2006
2001
114
15
92
133
69
62–70
69
69–70
Contrast-Induced Acute Kidney Injury:
3.0
2.9
3.6
3.58
3.1
2.5
3.6–3.7
3.48
34
35
iopentol
iopromide
iopentol
nonionic,
Lee [17] Taiwan, ROC 2007 82 65–69 4.9 4.9 iohexol low osmolality
Frank [14][18]
Reinecke
Marenzi [15]
Germany
Germany
Italy
2003
2007
2003
17
273
114
56–77
69
A Meta-Analysis of Randomized Controlled Trials
57.6–66.8 4.2
1.5
3.0
3.9
1.4
3.1
33
4 iopentol
iomeprol
iopromide
Marenzi [16] Italy 2006 92 69 3.6 3.6–3.7 4 iopentol
Lee [17] Taiwan, ROC 2007 82 65–69 4.9 4.9 5 iohexol
Key Words
Reinecke [18] Germany 2007 273 56–77Kai Song
ysis according
1.5 Shan Jiang
to the Yongbing Shi
1.4CKD stage
3 did not record Huaying Shen
heterogene-
iopromide Xiaosong Shi
Renal replacement therapy Contrast-induced acute ity across trials. RRT increased the odds of CI-AKI in CKD stage
kidney injury
TableHemodialysis Hemofiltration
2. Protocols of renal replacement therapy of included
Donghua Jing
3 patients
trials (RR1.53, 95% CI 0.07–0.64, p = 0.01), but decreased
the occurrence of CI-AKI in patients with CKD stage higher
Department of Nephrology, Second Affiliated Hospital of Soochow University, Suzhou, China
First author Time from contrast Duration
thanof3 (RRBlood
0.74, flow
95% CI Dialysate
0.35–1.60, flow,
p =ml/min
0.45). The pooledMembrane RRof
exposure to the start of RRT dialysis,
Abstract Table 2. Protocols of renal the hneed ml/min
for permanent dialysis demonstrated an insignifi-
replacement therapy of included trials
Background: Contrast-induced
Lehnert [10] acute
638 6 min kidney injury (CI-AKI)3 cant trend139 towards benefit
500 in patients treated with highRRTflux(RR
First
is an important author
Sterner cause
[11] of acute Time hfrominjury.
<3renal contrast Duration
Several clinical3 0.61,of95%Blood flow Dialysate
CI 0.26–1.40,
200 flow,RRT
p = 0.24).
500 ml/min
reducedMembranein-hospital
low flux
trials using replacementexposure
renal[12]
Berger therapy
1068 to(RRT)
25 minthe start
forofprevention
RRT dialysis, h
2–3mortality ml/min
compared with
220 500 control group (RR 0.33, 95% CI
low flux
Vogt [13]conflicting results.
of CI-AKI yielded 2 h We performed a meta-3 0.14–0.77,180 500
p = 0.01). Conclusion: RRT fails to reduce highthefluxinci-
Lehnert
Frank [10]
[14] 638 6 min
0prophylactic
(simultaneous) 34 139
200 in CKD500 500 high
high flux
flux
analysis toSterner
assess the efficacy of RRT on CI-AKI. dence of CI-AKI stage 3 patients, but may be benefi-
Marenzi[11][15] <30h(simultaneous) 3
22–30 200
100 500
replacement 1,000 ml/h low
highflux
flux
Methods:Berger
Randomized
Marenzi [16] controlled
[12] 1068 trials
25 minon CI-AKI using RRT
0 (simultaneous) 2–3 cial in patients
18–30 100 with more
220 500 advanced
replacement renal
1,000 ml/h function.
low CRRT
flux is
highflux
Vogt
were identified [13]
Lee [17]without language 2 h restriction
818 32 min in Cochrane li-34 more effective
180 500
150 than hemodialysis
500 for prevention highof flux
high CI-AKI.
flux
Frank
brary, Pubmed [14]
Reineckeand[18]
Embase. Data
<200 (simultaneous)
extracted from literature42 RRT is effective
min 200
180 in reducing500
500 the in-hospital mortality high flux
low flux of CI-
Marenzi [15] 0 (simultaneous) 22–30Key Words 100 replacement 1,000 ml/h high flux ysis according to the CKD stage did n
were analyzed with Review manager and Stata software. Re- AKI patients. Copyright © 2010 S. Karger AG, Basel
Marenzi [16] 0 (simultaneous) 18–30Renal replacement
100 therapy Contrast-induced
replacement 1,000 ml/h acute high flux ity acrosstrials. RRTincreased the odd
sults: NineLeerandomized
[17] controlled
818 32trials
min involving 751 pa-4 150 500 high flux
kidney injury Hemodialysis Hemofiltration 3 patients(RR1.53, 95%CI 0.07–0.64, p
 American Journal of

Nephrolo Am J Nephrol 2010;32:497–504 Received: July 18, 2010

Accepted: September 20, 2010
DOI: 10.1159/000321344
Published online: October 26, 2010

Renal Replacement Therapy for Prevention of

Contrast-Induced Acute Kidney Injury: In-Depth Topic Review
A Meta-Analysis of RandomizedNephrolo
Controlled Trials American Journal of

Am J Nephrol 2010;32:497–504 Re
Ac
DOI: 10.1159/000321344
Pu
Kai Song Shan Jiang Yongbing Shi Huaying Shen Xiaosong Shi
Donghua Jing
Department of Nephrology,
Study Second Affiliated Hospital of Soochow
Hemodialysis University, Suzhou
Control Weight, China
RR Year RR
or subgroup IV, random, 95% CI IV, random, 95% CI
events total
Renal Replacement Therapy for Prevention of
events total

1.1.1 Hemodialysis
Lehnert [10]
Sterner [11]
8
6
15
15
6
4
Contrast-Induced Acute Kidney Injury:
15
17
13.8%
12.3%
1.33 (0.61, 2.91)
1.70 (0.59, 4.90)
1998
2000
Vogt [13]
Berger [12]
24
3
55
7
20
1
A Meta-Analysis of Randomized Controlled Trials
58
8
15.2%
7.6%
1.27 (0.80, 2.01)
3.43 (0.45, 25.93)
2001
2001
Lee [17] 2 42 18 40 10.5% 0.11 (0.03, 0.43) 2007
Reinecke [18] 22 134 10 139 14.1% 2.28 (1.12, 4.64) 2007
Subtotal (95% CI) 268 277 73.3% to the1.21CKD
(0.63, 2.32)did not record heterogene-
Key Words
Total events 65 59
Kai Song Shan Jiang Yongbing Shi Huaying Shen Xiaosong Shi
ysis according stage
Renal replacementHeterogeneity:
therapy Contrast-induced acute
t 2 = 0.41; 2 = 15.96, ity Iacross
d.f. = 5 (p = 0.007); 2
= 69%trials. RRT increased the odds of CI-AKI in CKD stage
kidney injury Hemodialysis
Test for overallHemofiltration
effect: Z = 0.56 (p = 0.57)
Donghua Jing
3 patients (RR1.53, 95% CI 0.07–0.64, p = 0.01), but decreased
the occurrence of CI-AKI in patients with CKD stage higher
1.1.2 CRRT Department of Nephrology, Second Affiliated Hospital of Soochow University, Suzhou, China
than 3 (RR0.74, 95% CI 0.35–1.60, p = 0.45). The pooled RRof
Marenzi [15] 4 58 32 56 12.7% 0.12 (0.05, 0.32) 2003
Abstract Marenzi [16] 9 62 12 the
30 need for permanent
13.9% dialysis
0.36 (0.17, 0.77) demonstrated
2006 an insignifi-
Background: Contrast-induced
Subtotal (95% CI) acute kidney120 injury (CI-AKI) cant 86 trend towards0.22
26.7% benefit
(0.07,in patients treated with RRT (RR
0.64)
Total of
is an important cause events
acute renal 13 injury. Several clinical 0.61, 95% CI 0.26–1.40, p = 0.24). RRT reduced in-hospital
Heterogeneity: t 2 = 0.41; 2 = 3.10, d.f. = 1 (p = 0.08); I 2 = 68%
trials using renal replacement therapy (RRT) for prevention mortality compared with control group (RR 0.33, 95% CI
Test for overall effect: Z = 2.77 (p = 0.006)
of CI-AKI yielded conflicting results. We performed a meta- 0.14–0.77, p = 0.01). Conclusion: RRT fails to reduce the inci-
analysis to assess the efficacy
Total (95% CI)of prophylactic388 RRT on CI-AKI. 363 dence 100.0%
of CI-AKI in 0.74
CKD(0.35,
stage1.60)
3 patients, but may be benefi-
Total events
Methods: Randomized controlled 78 103
trials on CI-AKI using RRT cial in patients with more advanced renal function. CRRT is
Heterogeneity: t 2 = 0.95; 2 = 43.86, d.f. = 7 (p < 0.00001); I 2 = 84%
were identified without language restriction
Test for overall effect: Z = 0.76 (pin=Cochrane
0.45) li- more effective than hemodialysis for prevention 0.01 0.1of CI-AKI.
1 10 100
brary, Pubmed and Embase. Data extracted from literature RRT is effective in reducing the in-hospital mortality Favours RRTof Favours
CI- control
Key Words ysis according to the CKD stage did n
were analyzed with Review manager and Stata software. Re- AKI patients. Copyright © 2010 S. Karger AG, Basel
Renal replacement therapy Contrast-induced acute ity acrosstrials. RRTincreased the odd
sults: Nine randomized controlled trials involving 751 pa-
Fig. 2. Effect of modality of RRT on CI-AKI. kidney injury Hemodialysis Hemofiltration 3 patients(RR1.53, 95%CI 0.07–0.64, p
 American Journal of

Nephrolo Am J Nephrol 2010;32:497–504 Received: July 18, 2010

Accepted: September 20, 2010
DOI: 10.1159/000321344
Published online: October 26, 2010

Renal Replacement Therapy for Prevention of

Contrast-Induced Acute Kidney Injury: In-Depth Topic Review
A Meta-Analysis of RandomizedNephrolo
Controlled Trials American Journal of

Am J Nephrol 2010;32:497–504 Re
Ac
DOI: 10.1159/000321344
Pu
Kai Song Shan Jiang Yongbing Shi Huaying Shen Xiaosong Shi
Donghua Jing
Study RRT Control Weight RR Year RR
or subgroup
Department of Nephrology, Secondevents
Affiliatedtotal
Hospital of IV, random, 95% CI IV, random, 95% CI
evSoochow
ents totalUniversity, Suzhou, China

1.2.1 Baseline CKD stage 3

Lehnert [10] 8 15 6 15
Renal Replacement Therapy for Prevention of
13.8% 1.33 (0.61, 2.91) 1998
Sterner [11]
Berger [12]
6
3
15
7
4
1
17
8 Contrast-Induced Acute Kidney Injury:
12.3%
7.6%
1.70 (0.59, 4.90)
3.43 (0.45, 25.93)
2000
2001
Vogt [13] 24 55 20 58 15.2% 1.27 (0.80, 2.01) 2001
Reinecke [18]
Subtotal (95% CI)
22 134
226
10 139
237
A Meta-Analysis of Randomized Controlled Trials
14.1%
62.9%
2.28 (1.12, 4.64)
1.53 (1.10, 2.12)
2007

Total events 63 41
Heterogeneity: t 2 = 0.00; 2 = 2.63, d.f. = 4 (p = 0.62), I 2 = 0%
Key WordsTest for overall effect: Z = 2.54 (p = 0.01) Kai Song Shan Jiang Yongbing Shi Huaying Shen Xiaosong Shi
ysis according to the CKD stage did not record heterogene-
Renal replacement therapy Contrast-induced acute ity across trials. RRT increased the odds of CI-AKI in CKD stage
1.2.2 Baseline CKD stage higher than 3
kidney injury Hemodialysis Hemofiltration Donghua Jing
3 patients (RR1.53, 95% CI 0.07–0.64, p = 0.01), but decreased
Marenzi [15] 4 58 32 56 12.7% 0.12 (0.05, 0.32) 2003
Marenzi [16] 9 62 12 the occurrence
30 Department
13.9% 0.36 of CI-AKI
(0.17, in patients
0.77) Second
2006 with CKD stage higher
of Nephrology, Affiliated Hospital of Soochow University, Suzhou, China
Lee [17] 2 42 18 40 10.5%
than 0.11 (0.03,
3 (RR0.74, 95% 0.43) 2007 p = 0.45). The pooled RRof
CI 0.35–1.60,
Abstract Subtotal (95% CI) 162 126 37.1%
the 0.19
need for (0.08, 0.43)dialysis demonstrated an insignifi-
permanent
Total events 15 62
Background: Contrast-induced
Heterogeneity: t 2 = 0.29;acute kidney
2 = 4.24, d.f. =injury (CI-AKI)
2 (p = 0.12), cant trend towards benefit in patients treated with RRT (RR
I 2 = 53%
is an important cause
Test for ofeffect:
overall acuteZ renal
= 3.90 injury. Several clinical 0.61, 95% CI 0.26–1.40, p = 0.24). RRT reduced in-hospital
(p < 0.0001)
trials using renal replacement therapy (RRT) for prevention mortality compared with control group (RR 0.33, 95% CI
Total (95% CI) 388 363 100.0%
of CI-AKI yielded conflicting results. We performed a meta- 0.14–0.77, p0.74 (0.35, 1.60)
= 0.01). Conclusion: RRT fails to reduce the inci-
Total events 78 103
analysis to assess the efficacy
2 of prophylactic
2 RRT on CI-AKI. 2dence of CI-AKI in CKD stage 3 patients, but may be benefi-
Heterogeneity: t = 0.95; = 43.86, d.f. = 7 (p < 0.00001), I = 84%
0.01
Methods: Randomized
Test for overallcontrolled trials
effect: Z = 0.76 (p on CI-AKI using RRT cial in patients with more advanced
= 0.45) renal0.1function.1
CRRT 10
is 100
Favours RRT Favours control
were identified without language restriction in Cochrane li- more effective than hemodialysis for prevention of CI-AKI.
brary, Pubmed and Embase. Data extracted from literature RRT is effective in reducing the in-hospital mortality of CI-
Key Words ysis according to the CKD stage did n
were analyzed with Review
Fig. 3. Effect manager
of baseline and Stata
CKD stage software. Re- AKI patients.
on CI-AKI. Copyright © 2010 S. Karger AG, Basel
Renal replacement therapy Contrast-induced acute ity acrosstrials. RRTincreased the odd
sults: Nine randomized controlled trials involving 751 pa-
kidney injury Hemodialysis Hemofiltration 3 patients(RR1.53, 95%CI 0.07–0.64, p
Incidence, morbidity, and mortality of contrast-induced
acute kidney injury in a surgical intensive care unit:
A prospective cohort study☆ ,☆ ☆ ,★ Journal of Critical Care (2012) 27, 322.e1–322.e5
Xavier Valette MD a,⁎, Jean-Jacques Parienti MD, PhD b , Benoit Plaud MD, PhD a,
Philippe Lehoux MD a, Désiré Samba MD a, Jean-Luc Hanouz MD, PhD a
a
• Incidence 19% (95% CI, 11-26)
Anesthesia and surgical intensive care medicine, University hospital, Caen, France
b
Clinical Research, University hospital, Caen, France

Keywords: Abstract
Contrast-induced acute
Purpose: Data on contrast-induced acute kidney injury (CI-AKI) in intensive care unit (ICU) are scarce
kidney injury;
and controversial. The objectives of the study were to evaluate the incidence and characteristics of
Contrast medium;
Intensive care medicine
CI-AKI in a surgical ICU. Incidence, morbidity, and mortality of contra
Materials and Methods: We conducted a 13-month prospective observational study. Three definitions
acute kidney injury in a surgical intensive ca
were compared to characterize CI-AKI: Barrett and Parfrey criteria; Risk of renal dysfunction, Injury to
the kidney, Failure of kidney function, Loss of kidney function and End stage renal disease (RIFLE)
☆ ,☆ ☆ ,★
A prospective cohort study
classification; and Acute Kidney Injury Network (AKIN) criteria. Patients hospitalized in surgical ICU
who had received an injection of contrast medium, who were not on renal replacement therapy, who had
stable serum creatinine before injection, and no other etiology for new acute kidney injury were included.
a,⁎ b
Xavier Valette MD , Jean-Jacques Parienti MD, PhD , Benoit P
Results: One hundred one patients were included. The frequency of CI-AKI was 17%, 19%, and 19%
a respectively. Diabetes a
Philippe Lehoux MD , Désiré Samba MD , Jean-Luc Hanouz MD
according to Barrett and Parfrey criteria; RIFLE classification; and AKIN criteria,
mellitus, creatinine clearance less than 60 mL/min, and concomitant aminoglycoside administration were
associated with CI-AKI. Statistically significant associations were found between CI-AKI and renal
a
replacement therapy with all 3 definitions and Anesthesia and surgical
between CI-AKI intensive
and mortality careAKIN
when medicine, University hospital, Caen, France
criteria
b
were used. Clinical Research, University hospital, Caen, France
Conclusions: These results show that CI-AKI is not inconsequential in critically ill patients. In the
present study, AKIN criteria appear to be most relevant to define CI-AKI. Further studies are
required to explore CI-AKI prevention in ICU.
© 2012 Elsevier Inc. All rights reserved.
Keywords:
Abstract
Contrast-induced acute
Purpose: Data on contrast-induced acute kidney injury (CI-AKI) in i
kidney injury;
and controversial. The objectives of the study were to evaluate th
Contrast medium;
CI-AKI in a surgical ICU.
Intensive care medicine