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Journal Club - 2007-09-25
Sinert R, Doty CI et al. "Evidence-based emergency medicine review. Prevention of contrast-induced nephropathy in the emergency department". Annals of Emergency Medicine 2007;50 (3): 335-45, 345.e1-2. DOI:10.1016/j.annemergmed.2007.01.023. PMID 17512638.
- More recent RCT:
- Briguori C et al. "Renal Insufficiency Following Contrast Media Administration Trial (REMEDIAL): a randomized comparison of 3 preventive strategies". Circulation 2007;115 (10): 1211-7. PMID 17309916.
- Prior reviews
- Barrett BJ et al. "Clinical practice. Preventing nephropathy induced by contrast medium". N. Engl. J. Med. 2006;354 (4): 379–86. DOI:10.1056/NEJMcp050801. PMID 16436769. " 0.9 percent saline at 1 ml per kilogram per hour intravenously from up to 12 hours before administration of contrast medium and for up to 12 hours after"
- Pannu N et al. "Prophylaxis strategies for contrast-induced nephropathy". JAMA 2006; 295 (23): 2765-79. DOI:10.1001/jama.295.23.2765. PMID 16788132. normal saline or isotonic bicarbonate
- PIER: "Prevent contrast nephropathy due to iodine contrast in patients with renal insufficiency by hydrating and using acetylcysteine". [0.45% saline at 1 mg/kg·h for 12 hours before and 12 hours after]
- UpToDate: "If there are no contraindications to volume expansion, we recommend
isotonic intravenous fluids prior to and continued for several hours
after contrast administration (Grade 1B). The optimal type of fluid and timing of administration are not well established. We suggest isotonic bicarbonate rather than isotonic saline. An alternative regimen, which has been evaluated in the majority of trials, is the administration of isotonic saline."
Wong MC et al. "Effects of treatments for symptoms of painful diabetic neuropathy: systematic review". BMJ 2007;335 (7610): 87. DOI:10.1136/bmj.39213.565972.AE. PMID 17562735.>
Rabin A et al. "The sensitivity of the seated straight-leg raise test compared with the supine straight-leg raise test in patients presenting with magnetic resonance imaging evidence of lumbar nerve root compression". Archives of physical medicine and rehabilitation 2007;88 (7): 840-3. DOI:10.1016/j.apmr.2007.04.016. PMID 17601462.