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Results: 8

Dopamine versus no treatment to prevent renal dysfunction in indomethacin‐treated preterm newborn infants

Dopamine has not been shown to prevent adverse effects of indomethacin on the kidneys of preterm babies. Indomethacin is a drug used in preterm babies to prevent brain hemorrhage or to help close off PDA (patent ductus arteriosus ‐ when a channel between the lungs and heart does not close off after birth as it should). Indomethacin often causes fluid retention and reduced flow of urine, which can sometimes cause deterioration in kidney (renal) function. The drug dopamine is sometimes used along with indomethacin to try and prevent negative impact on the kidneys. The review found there is not enough evidence from trials to show there is any value in giving dopamine to babies being treated with indomethacin.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Low‐dose dopamine for women with severe pre‐eclampsia

No data on the use of low‐dose dopamine in women with severe pre‐eclampsia who have very low urine output.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Is continuous renal replacement therapy beneficial for people with rhabdomyolysis?

Rhabdomyolysis is a potentially life‐threatening condition where damaged muscle tissue breaks down quickly, and products of damaged muscle cells are released into the bloodstream. Of these products, a protein called myoglobin is harmful to kidney health and can lead to acute kidney injury. There is some evidence to suggest that continuous renal replacement therapy (CRRT) may provide benefits for people with rhabdomyolysis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Diuretics for respiratory distress syndrome in preterm infants

There is not enough data to support the routine use of diuretics for respiratory distress syndrome in newborn babies. Diuretics are drugs that increase the production of urine by encouraging salt and water to be released from the kidneys. When newborn babies have respiratory distress syndrome (RDS), their lungs may also contain excess fluid that can cause breathing problems. Babies with RDS sometimes may also have a reduced urine output. Using diuretics in these babies may improve lung or kidney function transiently, but may also increase cardiovascular complications. The review of trials did not find enough evidence supporting the routine use of diuretics in these infants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

NSAIDs used for pain relief after surgery may have only small, temporary negative effects on kidney function in adults with normal renal function

Nonsteroidal anti‐inflammatory drugs (NSAIDs) can be used to try and relieve pain after surgery. However, there have been concerns about the possible harmful effects of these drugs on the kidneys. The review of trials found that NSAIDs can cause small, temporary negative effects on the kidneys in adults, but no one in the trials experienced renal failure or serious kidney problems. These results may not apply to children or adults with decreased kidney function

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Prolonged versus short course of indomethacin for the treatment of patent ductus arteriosus in preterm infants

The ductus arteriosus is a blood vessel that connects the aorta and pulmonary artery. The ductus arteriosus is normally present in the fetus. It allows the majority of the output of the right side of the heart to bypass the lungs and supply the body of the fetus and placenta in‐utero. In most term infants the patent ductus arteriosus (PDA) closes within days of birth, first by contraction of a muscular layer to achieve functional closure and then by endothelial remodeling. If the ductus arteriosus persists, blood is shunted from the aorta to the pulmonary circulation, which can cause overloading of the pulmonary circulation and reduced perfusion of the brain, gut and kidneys. In preterm infants, closure may be delayed or fail to occur, due in part to circulating vasodilatory prostaglandins. Indomethacin inhibits prostaglandin synthesis and it is used to treat PDA in preterm infants. Although indomethacin is successful in closing the PDA in the majority of cases, the ductus will re‐open in up to 35% of infants who initially respond to the drug and a more prolonged course of indomethacin has been studied to achieve higher rates of ductal closure. Important side effects of indomethacin include renal dysfunction, decreased platelet aggregation, and necrotizing enterocolitis (NEC). Where indomethacin fails, the ductus arteriosus may be surgically ligated if clinically indicated. Five randomized trials are included in this review. These studies were published between 1988 and 2000 and included a total of 431 preterm and low birth weight infants. Indomethacin was given intravenously in four trials and orally in one, in total amounts of 0.6 to 1.6 mg/kg for the prolonged course (six to eight doses) and 0.3 to 0.6 mg/kg for the short course (two to three doses). There was no significant benefit of prolonged indomethacin administration on failure of the PDA to close after completion of allocated treatment (four studies, 361 infants). Prolonged course of indomethacin compared to the short course did not reduce the rate of PDA re‐opening after initial closure (three studies, 322 infants), rate of PDA re‐treatment (five studies, 431 infants), or ligation rate (four studies, 310 infants). The prolonged course was associated with decreased incidence of renal function impairment (three studies, 318 infants). However, a prolonged indomethacin course increased the risk of NEC (four studies, 310 infants). The number of deaths was no different.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Continuous infusion versus intermittent bolus doses of indomethacin for patent ductus arteriosus closure in symptomatic preterm infants

Patent ductus arteriosus (PDA) occurs when an artery near the heart and lungs stays open and does not close off after birth. Babies born early (preterm) have an increased risk of complications and death due to PDA. Indomethacin has been used to close the PDA; however, it can reduce blood flow in organs such as brain, kidneys and intestine. There is no agreement on the ideal dose and duration of treatment with indomethacin. In order to reduce the adverse effects of indomethacin on blood flow, some investigators have recommended administering the same total dose as a continuous infusion over 36 hours. In this review, the analysis of the two eligible trials found that the data was insufficient to reach a conclusion regarding the effectiveness of the 36‐hr continuous infusion method. The blood flow lowering side‐effects of indomethacin were reduced by the continuous infusion method, but there was insufficient data to recommend this administration method versus the traditional method.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Optimization of fluid levels in people suffering hip fractures

Hip fractures are common in elderly people, who often have medical conditions that put them at risk of developing other problems whilst their fracture is treated. Treatment usually involves an operation to fix the break in the bone, and it is possible that giving too much or too little fluid to a patient around this time may increase the risk of further problems. Healthcare staff can use many approaches in trying to determine how much fluid a patient needs in this situation, but it is not clear if some methods are better than others. For this Cochrane review, researchers from The Cochrane Collaboration looked at research on the effects of different methods of optimizing fluid levels for adult men and women who underwent surgery for any type of hip fracture. We searched the databases to October 2012 and identified three studies (randomized controlled trials) with a total of 200 people, each of which compared two or three methods of guiding fluid therapy. These methods include 'usual care' (where staff use changes in basic measurements, such as heart rate, to decide for themselves how much fluid to give), 'protocols using standard measures' (where staff use changes in basic measurements to give fluid according to a formal set of rules) and 'advanced haemodynamic monitoring' (where staff use equipment, such as specialized blood pressure monitoring devices placed into arteries, to guide how much fluid to give). These trials found no evidence that using one method instead of another reduces harm, including death or number of complications. One study suggests that length of stay in the hospital may be reduced if protocols or advanced haemodynamic methods are used, but because the number of people studied is not large, it is not possible to draw firm conclusions about this. No information was found regarding differences in the time taken for people to return to their previous type of accommodation or level of mobility. Two ongoing studies may provide more information in the future. The quality of evidence in a review may be high, moderate, low or very low. In this review, the evidence was assessed as being of low quality for all outcomes except time to medical fitness for discharge, for which the quality of evidence was moderate. Research findings to this point are insufficient to show how one can best optimize fluid levels in the large number of people around the world suffering from hip fracture. This is an update of a review published in 2004.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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