Abstract
IntroductionCurrent practices for renal replacement therapy in intensive care units (ICUs) remain poorly defined. The DOse REsponse Multicentre International collaborative initiative (DO-RE-MI) will address the issue of how the different modes of renal replacement therapy are currently chosen and performed. Here, we describe the study protocol, which was approved by the Scientific and Steering Committees.MethodsDO-RE-MI is an observational, multicentre study conducted in ICUs. The primary end-point will be the delivered dose of dialysis, which will be compared with ICU mortality, 28-day mortality, hospital mortality, ICU length of stay and number of days of mechanical ventilation. The secondary end-point will be the haemodynamic response to renal replacement therapy, expressed as percentage reduction in noradrenaline (norepinephrine) requirement. Based on the the sample analysis calculation, at least 162 patients must be recruited. Anonymized patient data will be entered online in electronic case report forms and uploaded to an internet website. Each participating centre will have 2 months to become acquainted with the electronic case report forms. After this period official recruitment will begin. Patient data belong to the respective centre, which may use the database for its own needs. However, all centres have agreed to participate in a joint effort to achieve the sample size needed for statistical analysis.ConclusionThe study will hopefully help to collect useful information on the current practice of renal replacement therapy in ICUs. It will also provide a centre-based collection of data that will be useful for monitoring all aspects of extracorporeal support, such as incidence, frequency, and duration.
Highlights
Current practices for renal replacement therapy in intensive care units (ICUs) remain poorly defined
The pathogenesis usually involves a nidus of infection, which progresses to a bloodstream infection, followed by activation of mediators and eventual shock or multiorgan failure [2]. Both septic shock and severe bacterial infections are associated with increased levels of plasma cytokines such as tumour necrosis factor-α, IL-1, IL-6, IL-8 and IL-10, IL-1 receptor antagonist, and soluble tumour necrosis factor receptors types I and II
The study is intended to describe current practices of renal replacement therapy (RRT) in all patients admitted to ICUs who are in need of RRT, with or without acute renal failure (ARF)
Summary
Current practices for renal replacement therapy in intensive care units (ICUs) remain poorly defined. Septic shock can be defined as sepsis with hypotension, despite adequate fluid resuscitation, along with evidence of perfusion abnormalities It is the leading cause of acute renal failure (ARF) and mortality in intensive care patients. The pathogenesis usually involves a nidus of infection, which progresses to a bloodstream infection, followed by activation of mediators and eventual shock or multiorgan failure [2] Both septic shock and severe bacterial infections are associated with increased levels of plasma cytokines such as tumour necrosis factor-α, IL-1, IL-6, IL-8 and IL-10, IL-1 receptor antagonist, and soluble tumour necrosis factor receptors types I and II. These mediators are produced in response to constituents of both Gram-negative and Gram-positive bacteria. Lipopolysaccharides of Gram-negative bacteria, and peptidoglycans, lipoteichoic acid and exotoxins of Gram-positive bacteria are largely responsible for the initial inflammatory cascade[3,4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
