The Value Of Sodium Bicarbonate Under The Condition Of Hydration In The Prevention Of Contrast Induced Nephropathy In Critically Ill Patients

Objective The aim of present study is to evaluate the role of sodiumbicarbonate under the condition of hydration in prevention of contrast inducednephropathy (CIN) in critically ill patients. Methods Retrospective methodwas employed to collect patients’ data from January2010to December2013in the general ICU of a teaching hospital. According to whetheradministration with0.9%NaCl or0.9%NaCl combining sodium bicarbonate,patients were divided into two groups, hydration group (Group H) andhydration combining sodium bicarbonate group (Group H+NaHCO3). Thechanges of serum creatinine（SCr） and estimated glomerular filtration rate（eGFR）were compared between the two groups before enhancement CTand on day1,2,3, and5after enhancement CT. The incidence of CIN in thetwo groups was also compared. Results In comparison with the basic valuesof SCr and eGFR, there were no significant differences in the Group H. As forthe Group H+NaHCO3, the level of eGFR increased significantly only on day5. When the comparison was taken between the two groups, it was found thatthe increase of SCr was significantly lower in Group H+NaHCO3than that ofGroup H on day2and day5(P <0.05). For the eGFR, The increase of eGFRwas significantly higher in Group H+NaHCO3than that of Group H on day2,3and5(P <0.05).(P <0.05). In addition, the incidence of CIN in GroupH+NaHCO3was9.5%according to the criteria of CIN, and was significantlylower than that in Group H (30.2%)(P <0.05). Conclusion On the basis of hydration, the administration of sodium bicarbonate before enhanced CTcould further reduce the incidence of CIN in the critically ill patients.