Fluid Balance of ICU Patients, Fluid Overload
Conditions
Keywords
furosemide, under strict conditions, normalize, ICU patients, fluid balance
Brief summary
Patients admitted in the Intensive Care Unit (ICU) frequently display and excessive fluid balance over a very short period of time. This positive fluid balance is the consequence of different organ failures (pulmonary, cardio-vascular, kidney…) or aggressive fluid resuscitation, which is mandatory in the early phase of ICU course. However recent data strongly suggest that an excessive fluid balance could be detrimental per se (increase of ICU morbidity or even mortality). There are controversies regarding the potential benefit of controlling this fluid balance with diuretics which are commonly used worldwide in various indications (acute and chronic heart failure, chronic kidney failure). In the ICU literature data are lacking, regarding the possible advantages and drawbacks of diuretics in this indication. The aim of our study is to test an algorithm with furosemide to reduce fluid overload in severe ICU-patients.
Interventions
DRUGFurosemide
Sponsors
Nantes University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age of 18 or more * Patients receiving endo-tracheal intubation and mechanical ventilation during their stay in the ICU * Weight increase of at least 3 % during the stay. Baseline weight is regarded as the weight at the 24th hour after ICU admission * FiO2 \< 60 %, PEEP \< 10cmH20 * No administration of catecholamines other than dobutamine at a dose of 10 microg.Kg-1.min-1
Exclusion criteria
* Pregnancy * Patient with a moribund state at ICU arrival * Acute brain injury (traumatic brain injury, subarachnoid hemorrhage, intra-cerebral bleeding, stroke, meningo-encephalitis, coma from medication origin) * Chronic kidney disease defined as creatinin clearance \< 30mL.min-1 and/or with chronic dialysis * Mandatory administration of diuretics (cardiogenic pulmonary oedema, LVEF \< 30 %)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evolution of fluid balance between randomisation and extubation (fluid balance in our study = Patient's weight at randomisation - Patient's initial weight (Kg) defined as the weight at admission) | Day 60 | Definition of fluid balance in our study = Patient's weight at randomisation - Patient's initial weight (Kg) defined as the weight at admission |
Secondary
| Measure | Time frame |
|---|---|
| Number of ventilatory-free days | Day 28 |
| Number of ICU-free days | Day 60 |
| Period of mechanical Ventilation | Day 60 |
| Extubation Failure | Day 60 |
| ICU Period of stay | Day 60 |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORKarim Asehnoune
Nantes University Hospital
PRINCIPAL_INVESTIGATORChristine LEBERT
Centre Hospitalier Departemental Vendee
Outcome results
None listed