Journal of Korean Clinical Nursing Research 2017;23(1):83-90

doi:10.22650/JKCNR.2017.23.1.83

Evidence-Based Clinical Practice Guideline for Fluid Therapy to Prevent Contrast-induced Nephropathy

Kyung Hae LEE 1 ; Kyung Min SHIN ; Hyeon Jeong LEE ; So Young KIM ; JungWon CHAE ; Mi Ra KIM ; Min Young HAN ; Mi Sook AHN ; Jin Kyung PARK ; Mi Ae CHUNG ; Sang Hui CHU ; Jung Hwa HWANG

Affiliations

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Keywords

Contrast Media; Acute Kidney Injury; Evidence-Based Practice; Fluid Therapy

Country

Republic of Korea

Language

Korean

Abstract

PURPOSE: This study was to develop evidence-based clinical practice guideline in order to prevent contrast-induced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). METHODS: The guideline was developed based on the “Scottish Intercollegiate Guidelines Network (SIGN)”. The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. RESULTS: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. CONCLUSION: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.