Controlled Fluid Removal in Critical Ill Patients With Fluid Overload in the Intensive Care Unit. (GODIF)

  • End date
    Jun 17, 2025
  • participants needed
  • sponsor
    Morten H. Bestle
Updated on 26 May 2022


This study evaluates the benefits and harms of goal directed fluid removal with furosemide versus placebo in critical ill adult patients with fluid overload in the intensive care unit. Half of the patients will receive furosemide and the other half placebo. The treatment will continue until the excess fluid is excreted.


Fluid overload is a common and serious complication in patients admitted to the intensive care unit (ICU). A core element of therapy in the ICU is resuscitation with crystalloid solutions. In many cases fluid accumulate, and patients become fluid overloaded. Several observational studies indicate a detrimental effect of fluid overload in different clinical settings, including patients with acute kidney injury. It is unknown whether this association is causal or if the increased tendency to accumulate fluid is a marker of disease severity and thereby a higher risk of death. The investigators want to investigate this in critical ill patients with fluid overload of 5% or more by randomizing them to furosemide (diuretics) or placebo.

Condition Fluid Overload
Treatment Furosemide, Isotonic saline
Clinical Study IdentifierNCT04180397
SponsorMorten H. Bestle
Last Modified on26 May 2022


Yes No Not Sure

Inclusion Criteria

ALL below must be met
Acute admission to the intensive care unit
Age ≥ 18 years of age
Fluid overload ≥ 5% of ideal body weight. If possible, all fluids administered before admission to the intensive care unit are to be included in the calculation of cumulative fluid balance
Clinical stable (minimum criteria: MAP > 50 mmHg and maximum infusion of 20 microgram/kg/minute of noradrenaline and lactate < 4.0 mmol/L)

Exclusion Criteria

Known allergy to furosemide or sulphonamides
Known pre-hospitalization advanced chronic kidney disease (eGFR < 30 mL/minute/1.73 m^2 or chronic RRT)
Ongoing renal replacement therapy
Anuria > 6 hours
Ongoing life-threatening bleeding as these patients need specific fluid/blood product strategies
Rhabdomyolysis with indication for forced diuresis
Acute burn injury of more than 10% of the body surface area as these patients need a specific fluid strategy
Severe dysnatremia (p-Na < 120 or > 155 mmol/L) as these patients need a specific fluid strategy
Severe hepatic failure as per the clinical team
Patients undergoing forced treatment
Fertile women (women < 50 years) with positive urine human chorionic gonadotropin (hCG) or plasma-hCG
Consent not obtainable as per the model approved for the specific trial site
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