Perfusion Parameters and Outcome During a Standardized Deresuscitation Strategy with Net Ultrafiltration: a Retrospective Cohort Study.

NCT06899880 | Completed

• 1 other identifier: 24-5563
• Study Type: observational
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

Hemodynamic tolerance of fluid removal during deresuscitation is a cornerstone of the impact on outcome of such a strategy. However, how to define and to predict hemodynamic tolerance to fluid removal remains controversial. The investigators routinely use a standardized deresuscitation protocol in patients with fluid overload and continuous renal replacement therapy combined with monitoring of clinical and biological perfusion parameters. The aim of the study was to describe perfusion during deresuscitation, and to determine whether it is associated with major adverse kidney events at day 30.

Conditions

Fluid Overload; Acute Kidney Injury; Continuous Renal Replacement Therapy

Outcome Measures

Primary Outcomes (1)

• MAKE 30

  Major adverse kidney event at day 30, defined as follows: * Death OR * No weaning of renal replacement therapy OR * Serum creatinine \> 2 times baseline serum creatinine

  A day 30 after the initiation of the deresuscitation strategy

Study Arms (1)

Standardized deresuscitation strategy

Eligible patients without hypoperfusion benefited from: 1) a restrictive approach of intakes combining hypercaloric enteral or per os feeding with hydric restriction as much as possible and no fluid of maintenance, and 2) a systematic UFnet of 2 mL/kg/h until reaching dry weight and a systematic monitoring every 6 h of: peripheral perfusion by capillary refilling time and mottling score, arterial lactate level, and central venous oxygen saturation.

Other: Describe the perfusion parameters during a deresuscitation strategy and their association with the outcome.

Interventions

Describe the perfusion parameters during a deresuscitation strategy and their association with the outcome. OTHER

Arterial lactate, pCO2 gap, SvO2, capillary refill time and mottling score anomalies will be described during the first 5 days of the deresuscitation strategy.

Standardized deresuscitation strategy

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

adults' patients with fluid overload and continuous renal replacement therapy in intensive care unit

You may qualify if:

• Age ≥ 18 years old
• Acute kidney injury requiring continuous renal replacement therapy
• Standardized deresuscitation following a routine care protocol

You may not qualify if:

• Chronic hemodialysis
• Advanced directives to withhold or withdraw life-sustaining treatment,
• Patient's opposition to the use of his/her personal health data

Sponsors & Collaborators

• Hospices Civils de Lyon: lead

Study Sites (1)

Louis Pradel Hospital

France, Bron, 69500, France

Location

MeSH Terms

Conditions

Edema; Acute Kidney Injury

Condition Hierarchy (Ancestors)

Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 21, 2025
• First Posted: March 28, 2025
• Study Start: January 1, 2024
• Primary Completion: March 1, 2024
• Study Completion: April 1, 2024
• Last Updated: March 28, 2025

Record last verified: 2025-03

Locations

FR (1)