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

조영제 유발 신장병증 예방을 위한 수액요법에 관한 근거기반 임상실무지침 개발

  • Lee, Kyung Hae (Division of Nursing, Yonsei University Health System) ;
  • Shin, Kyung Min (Division of Nursing, Yonsei University Health System) ;
  • Lee, Hyeon Jeong (Division of Nursing, Yonsei University Health System) ;
  • Kim, So Young (Division of Nursing, Yonsei University Health System) ;
  • Chae, Jung Won (Division of Nursing, Yonsei University Health System) ;
  • Kim, Mi Ra (Division of Nursing, Yonsei University Health System) ;
  • Han, Min Young (Division of Nursing, Yonsei University Health System) ;
  • Ahn, Mi Sook (Division of Nursing, Yonsei University Health System) ;
  • Park, Jin Kyung (Division of Nursing, Yonsei University Health System) ;
  • Chung, Mi Ae (Division of nursing, Yonsei University Health System) ;
  • Chu, Sang Hui (College of Nursing, Yonsei University) ;
  • Hwang, Jung Hwa (Division of Nursing, Yonsei University Health System)
  • Received : 2016.09.30
  • Accepted : 2017.02.16
  • Published : 2017.04.30

Abstract

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.

Keywords

References

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