Acute Kidney Injury, ARDS, Human
Conditions
Keywords
Renal Doppler
Brief summary
This is a multicenter international observational prospective cohort study. The main questions it aims to answer are: * PRIMARY AIM: To describe the capability of IRVF demodulation at diagnosis of ARDS to predict development of AKI within 7 days from the ARDS onset * SECONDARY AIMS: A)Describe the capability of IRVF demodulation or pattern of IRVF (continuous, pulsatility, biphasic, monophasic) to predict development of AKI within 14 days from the ARDS onset. B) To describe the RD parameters and VexUS in the AKI and no AKI patients over time. C) Describe the impact of invasive mechanical ventilation (IMV) on the intrarenal venous congestion and VexUS., D) Evaluation of effect of CRRT on IRVF pattern, VexUS and parameters. E) Describe the feasibility of renal doppler to assess IRVF in critically ill respiratory patients. F) Evaluate the incidence of AKD and CKD Participants will Adult patients with diagnosis of ARDS admitted to intensive care unit and undergoing invasive mechanical ventilation
Interventions
DIAGNOSTIC_TESTARDS+AKI
according to the clinical practice Reanl doppler and VeXUS score will be performed
Sponsors
Policlinico Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age \> 18 years * Critically ill patients admitted to intensive care unit with a diagnosis of ARDS according to Berlino criteria * Beginning of IMV less than 48 hours or Clinical decision to begin IMV. * Life expectancy \> 24 hours * Informed consent signed
Exclusion criteria
No patient will be excluded from the study because of gender, race, ethnicity, or sexual preference. * AKI prior to the onset of ARDS * Chronic respiratory failure due to chronic respiratory diseases * Chronic renal disease (CKD stage ≥ 2) and any ureteral obstruction. Definition of CKD patient is according to the latest guideline KDIGO * Chronic Heart Failure * Chronic liver disease * Major trauma in the past 3 months * Major surgery in the past 3 months * Smoking and Alcohol drinking * BMI ≥ 35 * Patients needing of VV-ECMO and VA-ECMO * Beginning of positive pressure ventilation more than 48 hours (invasive or no invasive) * Life expectancy \<24 hours * Cardio Circulatory Arrest * Neoplasm in chemotherapy/radiotherapy * Do Not Resuscitate or Comfort Measures * Pregnancy at ICU admission * Refused Informed Consent by the patient or surrogate decision-maker
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| cumulative incidence | 1st april 2024 - 31st of january 2026 | Cumulative incidence of AKI within 7 days from the ARDS onset in demodulated and no-demodulated group |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| AKIstage | 1st april 2024 - 31st of january 2026 | VM, RIhil and RIintra, SI, VexUS values in AKI and no AKI patients and in the different AKI stage |
| cross talk lung-kidney | 1st april 2024 - 31st of january 2026 | invasive mechanical ventilation parameters (PEEP, Pressure of plateau, driving pressure and static compliance of the respiratory system) values and PaCO2 and PaO2/FiO2 values in the demodulated or in any IRVF pattern (continuous, pulsatility, biphasic and monophasic) |
| AKI14 | 1st april 2024 - 31st of january 2026 | ) Incidence of AKI within 14 days from the ARDS onset in patient with and without IRVF demodulated or with different IRVF pattern |
| incidence of failed exam | 1st april 2024 - 31st of january 2026 | Percentage of exams successfully performed among the total of patients admitted to study |
| CKD progression | 1st april 2024 - 31st of january 2026 | Incidence of CKD Incidence of CKD Cumulative Incidence of CKD |
| CRRT | 1st april 2024 - 31st of january 2026 | IRVF pattern (continuous, pulsatility, biphasic, monophasic), VM, RIhil and RIintra, IRVFhil, SI and VexUS at the beginning and at the discontinuation of CRRT |
Outcome results
None listed