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KMID : 1004620170230010083
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Clinical Nursing Research
2017 Volume.23 No. 1 p.83 ~ p.90
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Evidence-Based Clinical Practice Guideline for Fluid Therapy to Prevent Contrast-induced Nephropathy
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Lee Kyung-Hae
Shin Kyung-Min
Lee Hyeon-Jeong
Kim So-Young
Chae Jung-Won
Kim Mi-Ra
Han Min-Young
Ahn Mi-Sook
Park Jin-Kyung
Chung Mi-Ae
Chu Sang-Hui
Hwang Jung-Hwa
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Abstract
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Purpose: This study was to develop evidence-based clinical practice guideline in order to prevent contrastinduced
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.
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KEYWORD
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Contrast Media, Acute Kidney Injury, Evidence-Based Practice, Fluid Therapy
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