Table 4.
Change Strategies For Evaluation and Further Consideration
NPO with clear fluids allowed up to 2–4 hours prior to PCI |
N-acetylcysteine 1200mg PO q12° x 4, first dose 6pm night before PCI: 1200mg dose @ 6PM, 6AM, 6PM, 6AM |
Standardization of volume administration prophylaxis |
IV NS @ 1.5mL/kg/hr at 10pm night before PCI, continue until IV NaHCO3 protocol begins |
IV NaHCO3 @ 3mL/kg/hr for 1 hour pre-PCI (reduce to 1mL/kg/hr if PCI is delayed) |
IV NaHCO3 @ 1mL/kg/hr for 6 hours post-PCI |
Recommendation: Post-discharge follow-up at 3–5 days to determine CI-AKI, if persistent weekly labs until resolved |
Iopamidol low-osmolar contrast agent |
CI-AKI = contrast-induced acute kidney injury; PCI = percutaneous coronary intervention; IV=intravenous; NS = normal saline; NaHCO3 = sodium bicarbonate (1000mL D5W mixed with 150 mEq NaHCO3).