Continuous Renal Replacement Therapy, Critically Ill, Fluid Overload, Fluid Removal
Conditions
Keywords
Fluid removal, Hemodynamic, Net ultrafiltration, Continuous renal replacement therapy
Brief summary
Macrohemodynamic impact of fluid removal with net ultrafiltration in patients with continuous renal replacement therapy. A monocentric ancillary study of the EarlyDry randomized controlled trial.
Interventions
OTHERMacrohemodynamic parameters
Macrohemodynamic parameters will be estimated with transpulmonary thermodilution every 6 hours during the intervention period (5 days). * Cardiac index * Extravascular lung water index * Pulmonary vascular permeability index * Cardiac function index * Global end-diastolic volume index * Central venous pressure * Fluid responsivness status (passive leg rising test)
Sponsors
Hospices Civils de Lyon
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Acute kidney injury treated by continuous renal replacement therapy in ICU less than 7 days, * At least 1 organ failure during ICU in addition to AKI (mechanical ventilation or vasopressors administration\>12 hours), * Cumulative UF net less than 1000ml before inclusion, * Norepinephrine \< 0,5 µg/kg/min, * Absence of hypoperfusion signs, * Fluid overload defined as follows: fluid overload \> 5% of base weight (based on cumulative fluid balance or a weight gain) and/or peripheral edema (AKIKI edema scale \> 2).
Exclusion criteria
* Chronic renal failure hemodialyzed before admission to the ICU, * Mechanical circulatory support (ECMO, LVAD), * Pregnant, child -bearing age or lactating women, * Stroke less than 30 days, * Intestinal ischemia less than 7 days documented non-operated, * Interventional study participation or exclusion period on going, * Guardianship, curatorship or safeguard of justice, * Absence of signature of free and informed consent by the patient and/or relative, * Patients not affiliated to a social security scheme or beneficiaries of a similar scheme * Absence of transpulmonary thermodilution monitoring
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Area under the curve of a low cardiac index | Every 6 hours between day 0 to day 5 (intervention period) | Area under the curve of a cardiac index \< 2.4 L/min/m2 (L/min/m2.hr), determined by transpulmonary thermodilution every 6 hours, with three boli of cold saline in the superior vena cava territory. |
Countries
France
Outcome results
None listed