None listed
Conditions
Brief summary
The use of diuretics in critically ill patients is widespread. Indications include the management of volume overload, maintenance of acid-base balance and potassium homeostasis. Commonly used diuretics include frusemide and acetazolamide. Despite the common use of these drugs there is no high quality evidence available comparing the effect of these drugs on the haemodynamic status and metabolic status of critically ill patients. We aim to evaluate the comparative effect of a standard dose of intravenous frusemide vs a standard dose of acetazolamide in critically ill patients. We plan to enrol a total of twenty-four patients in whom a decision has been made to administer a diuretic. These twenty-four patients will then be randomly assigned to receive a single dose of either frusemide of acetazolamide. To understand the effect of the diuretic administration, we will retrieve routinely recorded patient demographic data, haemodynamic data (such as blood pressure, heart rate, central venous pressure and cardiac output), data from the arterial blood gas samples (serum creatinine, sodium and potassium) as well as urine from the patient’s existing indwelling urinary catheter. The results of this study will provide insight into the effects of these two diuretics on electrolyte imbalances and the haemodynamic status of critically ill patients.
Interventions
A single 500 milligram (mg) intravenous dose of Acetazolamide will be administered by an intensive care nurse following the prescription by the patient's treating intensive care doctor
Sponsors
Austin Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Admission to the Austin Hospital ICU Age 18 years or greater An attending physician’s decision to administer a diuretic An anticipated ICU length of stay of >24 hours after frusemide administration Patients with existing intra-arterial cannulae or central venous catheters for blood sampling, and indwelling urinary catheters.
Exclusion criteria
Patients with known allergy to frusemide or acetazolamide or other sulphonamides. Known existing end stage renal failure Long-standing use of diuretic therapy Dose of different diuretic in the preceding 12 hours. Significant pre-existing acid-base disturbance at time of enrolment (pH < 7.30 or > 7.50) Patient receiving continuous renal-replacement therapy
Outcome results
None listed