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Sodium bicarbonate infusion in patients undergoing orthotopic liver transplantation: a single center randomized controlled pilot trial

Weinberg, Laurence, Broad, Jeremy, Pillai, Param, Chen, Guangjun, Nguyen, Micheline, Eastwood, Glenn M., Scurrah, Nick, Nikfarjam, Mehrdad, Story, David, Mcnicol, Larry and Bellomo, Rrinaldo 2016, Sodium bicarbonate infusion in patients undergoing orthotopic liver transplantation: a single center randomized controlled pilot trial, Clinical transplantation, vol. 30, no. 5, pp. 556-565, doi: 10.1111/ctr.12721.

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Title Sodium bicarbonate infusion in patients undergoing orthotopic liver transplantation: a single center randomized controlled pilot trial
Author(s) Weinberg, Laurence
Broad, Jeremy
Pillai, Param
Chen, Guangjun
Nguyen, Micheline
Eastwood, Glenn M.
Scurrah, Nick
Nikfarjam, Mehrdad
Story, David
Mcnicol, Larry
Bellomo, Rrinaldo
Journal name Clinical transplantation
Volume number 30
Issue number 5
Start page 556
End page 565
Total pages 10
Publisher Wiley-Blackwell Publishing
Place of publication Hoboken, N.J.
Publication date 2016-05
ISSN 0902-0063
1399-0012
Keyword(s) kidney injury
liver transplantation
Summary BACKGROUND: 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. METHODS: 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). Primary outcome: AKI within the first 48 h post-operatively.RESULTS: 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. CONCLUSIONS: The intra-operative infusion of sodium bicarbonate did not decrease the incidence of AKI in patients following orthotopic liver transplantation.
Language eng
DOI 10.1111/ctr.12721
Field of Research 110399 Clinical Sciences not elsewhere classified
1103 Clinical Sciences
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, John Wiley & Sons
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085607

Document type: Journal Article
Collection: School of Nursing and Midwifery
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