Intravenous Volume Expansion to Prevention Contrast-Induced Nephropathy at Nong Bua Lam Phu Hospital : การให้สารน้ำในหลอดเลือดดำเพื่อป้องกันการเกิดภาวะไตวายเฉียบพลันจากการฉีดสารทึบแสง ในผู้ป่วยที่มารับการบริการตรวจเอ็กซเรย์คอมพิวเตอร์ในโรงพยาบาลหนองบัวลำภู

Abstract

          This effective research study of historical-controlled design was a retrospective and prospective data collection. The objective was to study the efficacy of intravenous volume expansion to prevent contrast-induced nephropathy (CIN) in patients aged from18 years old. The study was conducted from January 1, 2017 to December 31, 2019. Three patient groups; without intravascular fluid infusion, receiving non-urgent intravascular fluid (0.9%NaCl) and receiving urgent intravascular fluid were compared. Data were analyzed using multivariable risk difference regression.

          The results showed that of total 177 patient samples, 62 patients did not received intravascular fluid, 57 patients received non-urgent intravascular fluid and 58 patients received urgent intravascular fluid. Their baseline characteristics were not difference in all 3 groups except sepsis and contrast media volume. After those differences were adjusted, patients who received intravascular fluid in both groups reduced the risk of CIN when compared to those did not receive intravascular fluid. It was found that the risk of CIN were reduced 8.9 times (95%CI; (-15.1)-(-2.6), p = 0.005) and 3.0 times (95%CI; (-9.1)-(3.1), p = 0.329) in patients receiving urgent and non-urgent intravascular fluid, respectively. Therefore, in establishing the guideline for intravenous volume expansion to prevent CIN, the urgent infusion with 0.9%NaCl 3 cc/kg/hr and non-urgent infusion with 0.9%NaCl 1 cc/ kg/hr, in case of contradictions, should be considered.

          Keywords : Intravenous Volume Expansion, Contrast-Induced Nephropathy (CIN), Contrast Media (CM)