Critical Illness, Kidney Failure, Respiratory Failure, Shock
Conditions
Keywords
Pulse pressure variation, Continuous venovenous hemodialysis, Volume status, Critical care
Brief summary
Dialysis is used to control the fluid balance and metabolic state of patients with kidney disease. Control of the metabolic state, via electrolytes, can be monitored using labs that are routinely drawn from patients undergoing continuous hemodialysis. Control of fluid removal is much more difficult. This study aims to determine whether changes in the blood pressure associated with breathing correlate with or predict intolerance to fluid responsiveness with continuous dialysis. We hypothesize that a measurement of changes in blood pressure with breathing called arterial pulse pressure variation may be able to predict the ability to remove fluid during continuous renal replacement therapy.
Interventions
None listed
Sponsors
University of Chicago
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age \> 17 years old * CVVHD renal replacement therapy * indwelling arterial line
Exclusion criteria
* age \< 18 years old * pregnancy * temperature \< 34°C * severe mechanical ventilator dyssynchrony * cardiac arrhythmias precluding automated PPV measurement by ICU monitors * non-pulsatile cardiac flow * open thoracic cavity
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Predictive value of pulse pressure variation for tolerance of fluid removal on CVVHD | Iterative 24 hr periods for the duration of CRRT |
Secondary
| Measure | Time frame |
|---|---|
| Increased doses of vasoactive agents on CRRT | Iterative 24 hr periods for the duration of CRRT |
| Inability to meet goal ultrafiltration rate | Iterative 24 hr periods for the duration of CRRT |
| Hypotensive events on CRRT | Iterative 24 hr periods for the duration of CRRT |
Countries
United States
Outcome results
None listed