Fluid Overload
Conditions
Brief summary
The ULTRA-Peds registry will employ a multi-center, single-arm, open-label, observational design to capture baseline, procedural and follow-up data on pediatric patients that have been treated (i.e., retrospective data from treatment at the time of registry approval by the IRB) or are scheduled to be treated (i.e., prospective data for on-label treatment after registry approval by the IRB) with Aquadex therapy according to local standard of care practices and decisions. All prospective data will be from on-label Aquadex treatment of pediatric patients weighing 20 kilograms or more. No data from prospective off-label treatment (i.e., Aquadex treatment with other adjunctive or conjunctive therapies for pediatric patients who may weigh less than 20kg) will be included in the registry. An estimated 10 sites in the United States who have received training in extracorporeal therapy and the Aquadex™ system will enroll a minimum of 500 patients.
Detailed description
The ULTRA-PEDs registry is designed to capture data in the real-World clinical setting on the Aquadex™ system in local standard of care, with the aim of understanding it's performance and utilization. Enrollment is expected to take approximately 2.5 years from the time the first patient is enrolled to the time the final patient is discharged from the hospital. ULTRA-PEDs will allow prospective and retrospective data collection for the following scenarios: * All prospective data for on-label use only (i.e., Aquadex ultrafiltration therapy for pediatric patients weighing 20 kg or more, whose fluid overload is unresponsive to medical management, including diuretics). * Retrospective patients at the time of registry approval by IRB regardless of on-label or off-label use. * Retrospective on-label use * Retrospective off-label use (i.e., Aquadex ultrafiltration with other adjunctive or conjunctive therapies for pediatric patients who may weigh less than 20kg)
Interventions
Ultrafiltration for fluid removal
Sponsors
Study design
Eligibility
Inclusion criteria
I. For enrollment in prospective data collection: 1. Patient age is 21 years or younger 2. Patient weighs 20 kilograms or more. 3. Patient or legally authorized representative provides written authorization or patient is hospitalized and receiving treatment in a center with an Institutional Review Board that has allowed for waived consent based on the type of data being collected for the Registry. 4. Patient is to undergo Aquadex therapy for fluid overload (i.e., fluid removal) as local standard of care. II. For enrollment in retrospective data collection: 1. Patient age is 21 years or younger. 2. Patient or legally authorized representative provides written authorization or patient is hospitalized and receiving treatment in a center with an Institutional Review Board that has allowed for waived consent based on the type of data being collected for the Registry. 3. Patient underwent Aquadex therapy for fluid overload (i.e., fluid removal) as local standard of care.
Exclusion criteria
1. Unable or unwilling to provide informed consent 2. Unable or unwilling to comply with study requirements
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Treatment Survival | Through completion of a treatment course, up to 3 months | Patient survive treatment course |
| Survival at ICU discharge | Through completion of a treatment course in the ICU, up to 1 month | % of ICU patients survive treatment in ICU |
| Change in Kidney Function | Change eGFR and renal labs from initiation to completion of treatment, up to 3 months | Assessment of Kidney function |
| Hemodynamic stability at initiation of UF therapy | From the time of index procedure is initiated up to 60 minutes after initiation | Need resuscitation fluids and medications (e.g. vasoactive medication) |
| Hemodynamic stability during treatment course | Through completion of a treatment course, up to 3 months | Need for vasoactive medication |
| Change % fluid overload during treatment course | Through completion of a treatment course, up to 3 months | % change in weight from initiation to the end of the last Aquadex procedure |
| Length of Stay in ICU | The time from admission to ICU through discharge from ICU, usually 1 month | Time of admission to ICU to discharge |
| Change in PRISM III Score | 2 hours before ICU admission through the first 4 hours after ICU discharge | Physiologic variables and labs to assess mortality risk |
| Aquadex related adverse events | Through completion of a treatment course, up to 3 months | Aquadex related adverse events |
Countries
United States