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Agarwal SK, Mohareb S, Patel A, Yacoub R, DiNicolantonio JJ, Konstantinidis I, Pathak A, Fnu S, Annapureddy N, Simoes PK, Kamat S, El-Hayek G, Prasad R, Kumbala D, Nascimento RM, Reilly JP, Nadkarni GN, Benjo AM. Systematic oral hydration with water is similar to parenteral hydration for prevention of contrast-induced nephropathy: an updated meta-analysis of randomised clinical data. Open Heart 2015; 2:e000317. [PMID: 26468404 PMCID: PMC4600249 DOI: 10.1136/openhrt-2015-000317] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/02/2015] [Accepted: 09/08/2015] [Indexed: 11/29/2022] Open
Abstract
Background Contrast-induced nephropathy (CIN) is the third most common cause of hospital-acquired kidney injury and is related to increased long-term morbidity and mortality. Adequate intravenous (IV) hydration has been demonstrated to lessen its occurrence. Oral (PO) hydration with water is inexpensive and readily available but its role for CIN prevention is yet to be determined. Methods PubMed, EMBASE and the Cochrane Central register of controlled trials (CENTRAL) databases were searched until April 2015 and studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All randomised clinical trials with head-to-head comparison between PO and IV hydration were included. Results A total of 5 studies with 477 patients were included in the analysis, 255 of those receiving PO water. The incidence of CIN was statistically similar in the IV and PO arms (7.7% and 8.2%, respectively; relative risk 0.97; 95% CI 0.36 to 2.94; p=0.95). The incidence of CIN was statistically similar in the IV and PO arms in patients with chronic kidney disease and with normal renal function. Rise in creatinine at 48–72 h was lower in the PO hydration group compared with IV hydration (pooled standard mean difference 0.04; 95% CI 0.03 to 0.06; p<0.001; I2=62%). Conclusions Our meta-analysis shows that systematic PO hydration with water is at least as effective as IV hydration with saline to prevent CIN. PO hydration is cheaper and more easily administered than IV hydration, thus making it more attractive and just as effective.
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Affiliation(s)
- Shiv Kumar Agarwal
- Division of Cardiovascular Diseases, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas , USA
| | - Sameh Mohareb
- Division of Cardiology, Department of Internal Medicine , Ochsner Clinic Foundation , New Orleans, Louisiana , USA
| | - Achint Patel
- Department of Public Health , Icahn School of Medicine at Mount Sinai , New York, New York , USA
| | - Rabi Yacoub
- Division of Nephrology, Department of Medicine , Icahn School of Medicine at Mount Sinai , New York, New York , USA
| | | | - Ioannis Konstantinidis
- Department of Medicine , Icahn School of Medicine at Mount Sinai , New York, New York , USA
| | - Ambarish Pathak
- Department of Public Health , New York Medical College , Valhalla, New York , USA
| | - Shailesh Fnu
- Division of Cardiovascular Diseases, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas , USA
| | - Narender Annapureddy
- Division of Rheumatology, Department of Medicine , Vanderbilt University Medical Center , Nashville, Tennessee , USA
| | - Priya K Simoes
- Department of Medicine , St Lukes Roosevelt Hospital Center at Mount Sinai , New York, New York , USA
| | - Sunil Kamat
- Division of Critical Care , Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute , Mumbai, Maharashtra , India
| | - Georges El-Hayek
- Department of Medicine , St Lukes Roosevelt Hospital Center at Mount Sinai , New York, New York , USA
| | - Ravi Prasad
- Division of Cardiology, Department of Internal Medicine , Ochsner Clinic Foundation , New Orleans, Louisiana , USA
| | - Damodar Kumbala
- Division of Nephrology, Department of Internal Medicine , Ochsner Clinic Foundation , New Orleans, Louisiana , USA
| | | | - John P Reilly
- Division of Cardiology, Department of Internal Medicine , Ochsner Clinic Foundation , New Orleans, Louisiana , USA
| | - Girish N Nadkarni
- Division of Nephrology, Department of Medicine , Icahn School of Medicine at Mount Sinai , New York, New York , USA
| | - Alexandre M Benjo
- Division of Cardiology, Department of Internal Medicine , Ochsner Clinic Foundation , New Orleans, Louisiana , USA
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Po JRF, Chaudhry FA, Balasundaram K, Shami W, Penesetti S, Kommaraju KK, Mohareb S, Patel S, Agarwal V, Argulian E. Prognostic Value of Stress Echocardiography in Patients Presenting with Syncope. Echocardiography 2015; 32:1352-8. [DOI: 10.1111/echo.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jose Ricardo F. Po
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Farooq A. Chaudhry
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Kiruthika Balasundaram
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Waseem Shami
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Sunil Penesetti
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Kiran K. Kommaraju
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Sameh Mohareb
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Suketukumar Patel
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Vikram Agarwal
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
| | - Edgar Argulian
- Mount Sinai St. Luke's and Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
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Supariwala AA, Po JRF, Mohareb S, Aslam F, Kaddaha F, Mian ZI, Chaudhry F, Otokiti A, Chaudhry FA. Prevalence and Long-Term Prognosis of Patients with Complete Bundle Branch Block (Right or Left Bundle Branch) with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiography. Echocardiography 2014; 32:483-9. [DOI: 10.1111/echo.12680] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Azhar A. Supariwala
- Mount Sinai St. Luke's and Roosevelt; Icahn School of Medicine at Mount Sinai; New York New York
| | - Jose Ricardo F. Po
- Mount Sinai St. Luke's and Roosevelt; Icahn School of Medicine at Mount Sinai; New York New York
| | - Sameh Mohareb
- Mount Sinai St. Luke's and Roosevelt; Icahn School of Medicine at Mount Sinai; New York New York
| | - Farhan Aslam
- Mount Sinai St. Luke's and Roosevelt; Icahn School of Medicine at Mount Sinai; New York New York
| | - Firas Kaddaha
- Mount Sinai St. Luke's and Roosevelt; Icahn School of Medicine at Mount Sinai; New York New York
| | - Zainab I. Mian
- Mount Sinai St. Luke's and Roosevelt; Icahn School of Medicine at Mount Sinai; New York New York
| | - Farhan Chaudhry
- Mount Sinai St. Luke's and Roosevelt; Icahn School of Medicine at Mount Sinai; New York New York
| | - Ahmed Otokiti
- Mount Sinai St. Luke's and Roosevelt; Icahn School of Medicine at Mount Sinai; New York New York
| | - Farooq A. Chaudhry
- Mount Sinai Hospital; Icahn School of Medicine at Mount Sinai; New York New York
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Abdel-Hady H, Mohareb S, Khashaba M, Abu-Alkhair M, Greisen G. Randomized controlled trial of discontinuation of nasal-CPAP in stable preterm infants breathing room air. Acta Paediatr 1998; 87:82-7. [PMID: 9510453 DOI: 10.1080/08035259850157921] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This trial assessed the consequences of discontinuation of nasal-CPAP in stable preterm infants breathing room air. Eighty-eight infants with a mean gestational age of 29 (24-33) weeks and a mean birthweight of 1264 (665-2060)g, randomized to either discontinuation of CPAP or its continuation, were clinically observed and monitored for 6 h by cardiorespiratory monitor, pulse oximeter and transcutaneous blood gas monitor. The abdominal circumference and gastric air and aspirate volumes were measured prior to meals at trial entry and after 6 h. Discontinuation of CPAP led to a small but significant decrease in oxygenation at 1 and 6 h. During the trial, five infants in the experimental group required supplemental oxygen and one infant was put back on CPAP owing to excessive apnoeas. Discontinuation of CPAP did not influence the TcPCO2 or the number of apnoeas and bradycardias during the trial, but led to significantly increased respiratory rate, retractions, and flaring at 6 h. It also led to a significant decrease in the abdominal circumference and gastric air volume. Thirty-nine percent of infants were put back on CPAP some time after the trial, mainly because of recurrent apnoeas and bradycardias. Taking the infant off CPAP during the trial reduced subsequent use of CPAP.
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Affiliation(s)
- H Abdel-Hady
- Department of Paediatrics, Mansoura Faculty of Medicine, Egypt
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