J Korean Clin Nurs Res.  2017 Apr;23(1):83-90. 10.22650/JKCNR.2017.23.1.83.

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

Affiliations
  • 1RN, Division of Nursing, Yonsei University Health System, Seoul, Korea.
  • 2Assistant Manager, Division of Nursing, Yonsei University Health System, Seoul, Korea. HWANGJH@yuhs.ac
  • 3Team Manager, Division of nursing, Yonsei University Health System, Seoul, Korea.
  • 4Associate Professor, College of Nursing, Yonsei University, Seoul, Korea.

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.

Keyword

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

MeSH Terms

Acute Kidney Injury
Bias (Epidemiology)
Contrast Media
Evidence-Based Practice
Fluid Therapy*
Humans
Percutaneous Coronary Intervention
Contrast Media
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