Use of Bedside Ultrasonography on the Incidence of Acute Renal Failure in High-risk Surgical Patients

This is a single-center randomized clinical trial to be performed at the Adult Intensive Care Unit (ICU) of the Clinical Hospital of the Federal University of Minas Gerais, Belo Horizonte. The ICU is a clinical-surgical unit that has 18 beds with admission of approximately 100 patients per month, being 70% surgical patients and 30% clinical patients. Postoperative patients who meet the inclusion criteria reported below will be randomized to guide therapy according to ultrasound findings at the bedside versus a group that will not perform this method. Serum and urine samples will be collected in three times: admission (T0), after 12 hours (T1) and after 24 hours (T2) to analysed urine and serum biomarkers.

Inclusion criteria

• Age equal or superior to 18 years.
• Major surgeries requiring ICU admission associated with one of the following criteria:

• Use of vasoactive drugs
• Use of inotropic drugs
• Mean blood pressure less than 65 mmHg or SBP <90 mmHg.
• Hyperlactatemia> 2 mmol / L
• Heart rate> 90 bpm.
• Invasive mechanical ventilation required for at least 6 hours at the time of inclusion.
• Hypoxia: satO2 <92% in ambient air.
• Length of surgery greater than 4 hours.
• Request for transfusion of blood products in a surgical block
• Oliguria during procedure, defined as diuresis <0.5 ml/kg/h.

Exclusion criteria

Patients who do not agree to the terms of the

• Dying patients with impending death in the first 24 hours
• Patients in a previous renal replacement therapy program