Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/19230
Title: Sodium bicarbonate infusion in patients undergoing orthotopic liver transplantation: a single center randomized controlled pilot trial.
Austin Authors: Weinberg, Laurence ;Broad, Jeremy;Pillai, Parameswan ;Chen, Guangjun;Nguyen, Micheline;Eastwood, Glenn M ;Scurrah, Nick ;Nikfarjam, Mehrdad ;Story, David A ;McNicol, Larry;Bellomo, Rinaldo 
Affiliation: Department of Anesthesia,Austin Health, Heidelberg, Victoria, Australia
Centre for Anesthesia, Perioperative and Pain Medicine, The University of Melbourne, Melbourne, Victoria, Australia
Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
Faculty of Health, School of Nursing & Midwifery, Deakin University, Heidelberg, Victoria, Australia
Austin Health, Heidelberg, Victoria, Australia
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
The University of Melbourne, Melbourne, Victoria, Australia
Department of Surgery and Centre for Anesthesia, Perioperative and Pain Medicine, The University of Melbourne, Melbourne, Victoria, Australia
Department of Anesthesiology, CHUM St-Luc Hospital, Montreal, QC, Canada
Faculty of MN&HS, Monash University, Heidelberg, Victoria, Australia
Issue Date: May-2016
metadata.dc.date: 2016-03-14
Publication information: Clinical transplantation 2016; 30(5): 556-65
Abstract: Liver transplantation-associated acute kidney injury (AKI) carries significant morbidity and mortality. We hypothesized that sodium bicarbonate would reduce the incidence and/or severity of liver transplantation-associated AKI. In this double-blinded pilot RCT, adult patients undergoing orthotopic liver transplantation were randomized to an infusion of either 8.4% sodium bicarbonate (0.5 mEq/kg/h for the first hour; 0.15 mEq/kg/h until completion of surgery); (n = 30) or 0.9% sodium chloride (n = 30). AKI within the first 48 h post-operatively. There were no significant differences between the two treatment groups with regard to baseline characteristics, model for end-stage liver disease and acute physiology and chronic health evaluation (APACHE) II scores, and pre-transplantation renal function. Intra-operative factors were similar for duration of surgery, blood product requirements, crystalloid and colloid volumes infused and requirements for vasoactive therapy. Eleven patients (37%) in the bicarbonate group and 10 patients (33%) in the sodium chloride group developed a post-operative AKI (p = 0.79). Bicarbonate infusion attenuated the degree of immediate post-operative metabolic acidosis; however, this effect dissipated by 48 h. There were no significant differences in ventilation hours, ICU or hospital length of stay, or mortality. The intra-operative infusion of sodium bicarbonate did not decrease the incidence of AKI in patients following orthotopic liver transplantation.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19230
DOI: 10.1111/ctr.12721
ORCID: 0000-0001-7403-7680
0000-0002-1650-8939
0000-0002-6479-1310
0000-0003-4866-276X
PubMed URL: 26915026
Type: Journal Article
Subjects: bicarbonate
kidney injury
liver transplantation
Appears in Collections:Journal articles

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