NAC, NaHCO3 and NS Prophylaxis for CTPA in the ED on Suspicion of PE: A Randomized Controlled Trial
Status:
Completed
Trial end date:
2015-02-01
Target enrollment:
Participant gender:
Summary
Study objective:
The purpose of this study was to compare the role of the prophylactic protocols
N-acetylcysteine (NAC) plus normal saline, sodium bicarbonate (NaHCO3) plus normal saline and
intravenous normal saline (NS) alone in the prevention of contrast-induced nephropathy (CIN)
after computed tomography pulmonary angiography (CTPA) in emergency patients with suspected
pulmonary embolism (PE).
Materials and methods:
This study was planned as randomized, double blind, placebo controlled clinical research.
Patients presenting to the emergency department within a 1-year period, undergoing CTPA on
suspicion of PE and having one or more risk factors for development of CIN were included in
the study. The NAC group received 1 ml/3 mgr NAC+NS solution 1 h before CTPA and 1 ml/kg per
hour for a minimum 6 h after CTPA. The NaHCO3 group received 132 mEq NaHCO3+NS solution for 1
h before CTPA and 1 ml/kg per hour for a minimum of 6h after CTPA. The normal saline (NS)
group received 3 ml/kg NS for 1 h before CTPA and 1 ml/kg per hour NS for a minimum 6 h after
CTPA. CIN was evaluated as the primary outcome, and moderate renal injury (defined as a 100%
increase in serum creatinine levels), severe renal insufficiency requiring hemodialysis or
peritoneal dialysis) or in-hospital mortality as secondary outcomes.