Continuous Renal Replacement Therapy, Fluid Overload, Hypovolemia, Intensive Care Unit
Conditions
Brief summary
The aim of the study is to analyze if blood protein concentration variation during continuous renal replacement therapy (CRRT) with fluid removal can predict a decrease of 15 % of cardiac index in intensive care unit (ICU) patients. Blood protein concentration, clinical data describing hemodynamic status (providing data from Pulsion medical system PiCCO2 ® monitoring), including preload dependency evaluation with passive leg raising, are collected at different times: before initiation of fluid removal, and after the first episode of hypotension or one hour after initiation of fluid removal.
Detailed description
The aim of the study is to analyze if blood protein concentration variation during continuous renal replacement therapy (CRRT) with fluid removal can predict a decrease of 15 % of cardiac index in intensive care unit (ICU) patients. Blood protein concentration, clinical data describing hemodynamic status (providing data from Pulsion medical system PiCCO2 ® monitoring), including preload dependency evaluation with passive leg raising, are collected at different times: before initiation of fluid removal, and after the first episode of hypotension or one hour after initiation of fluid removal.
Interventions
None listed
Sponsors
Hopital Louis Pradel
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* up to 18 years old * continuous renal replacement therapy * Suspicion of fluid overload * Prescription of fluid removal by the intensivist * PICCO2 monitoring
Exclusion criteria
* pregnancy * intra abdominal hypertension * Moribund patient * Abdominal hypertension
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| plasmatic protein concentration variation | 1 hour | Two sample of plasmatic protein before and after a fluid removal will be performed. The variation of the protein concentration (computed as the difference between final and baseline value divided by the baseline value expressed in %) will be the index test to diagnose a decrease of cardiac output of more than 15 % due to the fluid removal. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Plasmatic protein concentration in patient with preload dependency before fluid removal | 1 hour | hemoconcentration will be evaluated in the subgroup of preload dependent patients |
| Central venous pressure (CVP) | 1 hour | CVP will be tested to evaluate the diagnostic ability to diagnose a reduction of cardiac output due the fluid removal |
| Global end diastolic volume (GEDV) | 1 hour | GEDV, calculated with transpulmonary thermodilution will be tested to evaluate the diagnostic ability to diagnose a reduction of cardiac output due the fluid removal |
| Extravascular lung water (EVLW) | 1 hour | EVLW, calculated with transpulmonary thermodilution will be tested to evaluate the diagnostic ability to diagnose a reduction of cardiac output due the fluid removal |
| hemoconcentration evaluated with hemoglobin variation | 1 hour | hemoconcentration evaluated with hemoglobin variation will be tested to evaluate the diagnostic ability to diagnose a reduction of cardiac output due the fluid removal |
Countries
France
Contacts
Primary ContactMatthias Jacquet-Lagèze, M.D., M.Sc.
Backup ContactJean-Luc Fellahi, M.D.,Ph.D.
Outcome results
None listed