A pilot trial of single versus dual diuretic therapy in the intensive care unit

Status

Completed

Phases

Phase 2

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12623000624684

Enrollment

Registered

2023-06-07

Start date

2023-05-23

Completion date

2024-02-09

Last updated

2025-09-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Diuretics are commonly used in the intensive care unit with the aim of achieving a negative fluid balance; yet remarkably little is known about their pharmacodynamic properties in critically ill patients. The most frequently used class of diuretic drugs are the loop diuretics, and furosemide is the most commonly used loop diuretic. However, loop diuretics may have a number of undesirable side effects, including electrolyte derangements and metabolic alkalosis. This pilot trial will randomly allocate 40 patients (20 in each arm) to receive Furosemide only or Furosemide and Acetazolamide. The primary outcome is urinary output occurring in the 6 hours after diuretic administration while in the intensive care unit. Results will inform future clinical trials and the outcomes that will be selected for these future trials.

Interventions

Throughout the patient's admission to the intensive care unit and at the time the treating intensive care doctor has decided to administer an intravenous diuretic, a single intravenous bolus of 40 mg furosemide and 500 mg acetazolamide will be given with the effects monitored via medical record audit.

Study design

Allocation

Randomised controlled trial

Primary purpose

Treatment

Masking

Blinded (masking used) (Investigator)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

Adults aged 18 years or above Physician decision to administer an intravenous diuretic; Anticipated length of stay of more than 24 hours after intervention administration Existing intra-arterial or central venous catheter Existing indwelling urinary catheter

Exclusion criteria

Known allergy to furosemide or acetazolamide or other sulphonamides known end-stage renal failure Dose of any diuretic in the preceding 6 hours Significant acid-base disturbance at time of enrolment (pH less than 7.25 or greater than 7.5) Treatment with renal replacement therapy during this intensive care stay Previously enrolled in this study

Outcome results