Effect of Hydration Guided by Vigileo on the Prevention of CIN After PCI for Patients With AMI
Condition: Myocardial Infarction; Contrast-induced Nephropathy
MeSH terms: Kidney Diseases; Myocardial Infarction; Infarction
Study type: Interventional

Summary: 
      In this study, Vigileo is used to guide hydration adjustment, and SCr is used to estimate
      renal function. The aim of the study is to investigate the preventive effect of adequate
      hydration guided by Vigileo on contrast induced nephropathy in patients with acute myocardial
      infarction who undergo PCI.
    

Detailed description: 
      This study was conducted in patients with acute myocardial infarction who undergo emergency
      PCI in Chinese PLA General Hospital. The patients were randomly divided into two groups: the
      adequate hydration group guided by Vigileo and control group. For the adequate hydration
      group guided by Vigileo, Vigileo equipment is used to perform hemodynamic monitoring through
      the femoral or radial arteries to obtain relevant hemodynamic parameters (CO, SV, SVV), and
      the fluid-rehydration velocity of normal saline is adjusted according to the hemodynamic
      parameters, and the hydration also lasts 24 hours after operation. For the control group, the
      routine hydration regimen is adopted, perioperative saline ≤500 ml hydration. The changes of
      renal function (serum creatinine, serum cystatin), symptoms and signs of cardiac
      insufficiency during perioperative period and cardiac objective indexes are observed. The
      incidence of postoperative acute pulmonary edema is recorded, and the major cardiovascular
      events and hemodialysis events are followed up for 6 months. By comparing the perioperative
      indexes of heart and kidney function between the intervention group and the control group,
      the preventive effect of adequate hydration guided by Vigileo on contrast induced nephropathy
      after PCI was clarified.
    

Intervention name(s): the adequate hydration group guided by Vigileo
Intervention type(s): Procedure
Intervention description(s): If the patient is mechanically ventilated, the following scheme is adopted: if SVV≤10%, then adjust the rehydration speed to 1 ml/kg/h; if 10%<SVV<15%, then adjust the rehydration speed to 2 ml/kg/h; if SVV≥15%, then adjust the rehydration speed to 3 ml/kg/h. The hydration lasts 24 hours after operation, and the rehydration speed is changed according to the SVV. If the patient does not use mechanical ventilation, the following scheme is adopted: 250ml normal saline is administered within 10 minutes after direct PCI, and the rehydration volume changes to 125ml in patients with mild-to-moderate congestive heart failure. If the increment of SV≥15%, then adjust the rehydration speed to 3 ml/kg/h; if 10%≤the increment of SV<15%, then adjust the rehydration speed to 2 ml/kg/h; if the increment of SV<10%, then adjust the rehydration speed to 1 ml/kg/h. Reassessed every 1 hour until SV is stable，and the hydration also lasts 24 hours after operation.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Hydration; Contrast-induced Nephropathy; contrast induced acute kidney injury