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The renal Doppler resistive index (RRI) is a noninvasive tool that has been used to assess renal perfusion in the intensive care unit (ICU) setting. Many parameters have been described as influential on the values of renal RI. Mechanical ventilation is associated with significant increases in the risk of acute kidney injury (AKI). Ventilator-induced kidney injury (VIKI) is believed to occur due to changes in hemodynamics that impair renal perfusion. The investigators hypothesized that patients who need mechanical ventilation should have a different response in RRI when different levels of Positive end expiratory pressure (PEEP) are applied. Investigators wish to describe changing in RRI due to changes in PEEP and to verify whether these changes could partially explain the occurrence of VIKI
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Critically ill ventilated patients | Patients admitted to ICU with expected mechanical ventilation >48h |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PEEP changes | Procedure | All patients will be ventilated with a tidal volume of 6 ml/kg before the RRI assessment. Further, three level of PEEP (5, 10 and 15 cmH2O) will be randomly set. For each levels of PEEP, the RRI will be evaluated |
| Measure | Description | Time Frame |
|---|---|---|
| Occurence of AKI | AKI will be defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria | once a day until day 7 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in RRI at different level of PEEP | To compare median difference of RRI at PEEP 5 and PEEP 15 in patients who will develop (or not) AKI | One a day until day 5 |
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Inclusion Criteria:
Exclusion Criteria:
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Cohort of critically ill patients
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Università di Ferrara | Ferrara | 44121 | Italy | |||
| Università di Siena |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38771490 | Derived | Fogagnolo A, Grasso S, Morelli E, Murgolo F, Di Mussi R, Vetrugno L, La Rosa R, Volta CA, Spadaro S. Impact of positive end-expiratory pressure on renal resistive index in mechanical ventilated patients. J Clin Monit Comput. 2024 Oct;38(5):1145-1153. doi: 10.1007/s10877-024-01172-z. Epub 2024 May 21. |
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IPD will be shared under reasonable request to the principal investigator
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| D053120 | Respiratory Aspiration |
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D010335 | Pathologic Processes |
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| Siena |
| 53100 |
| Italy |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |