VExUS-guided Fluid Management in Patients With Acute Kidney Injury in the Intensive Care Unit (AKIVEX)

  • STATUS
    Recruiting
  • days left to enroll
    32
  • participants needed
    55
  • sponsor
    Hospital de Clinicas de Porto Alegre
Updated on 22 March 2022
renal replacement therapy

Summary

A quasi experimental study that aims to verify whether the incorporation of VExUS in patients with AKI in the Intensive Care Unit (ICU) may prompt tailored interventions to increases the number of days free from Renal Replacement Therapy (RRT) during the first 28 days.

Description

Fluid overload is associated with organ dysfunction, such as Acute Kidney Injury (AKI), and increased mortality. It remains unclear if fluid overload is merely an epiphenomenon in critically ill patients or if organ congestion is a mediator of complications. Considering AKI related to fluid overload, diuretic therapy would reduce venous congestion and improve renal blood flow. The Venous Excess Ultrasound score (VExUS) identifies clinically significant venous congestion and indicates a high risk of post-operative AKI. This quasi-experimental study aims to verify whether the incorporation of VExUS in patients with AKI in the Intensive Care Unit (ICU) may prompt tailored interventions to increases the number of days free from Renal Replacement Therapy (RRT) during the first 28 days.

Details
Condition Acute Kidney Injury, Renal Insufficiency, Acute, Kidney; Disease, Acute, Critical Illness, Volume Overload, Fluid Overload
Treatment VExUS score
Clinical Study IdentifierNCT05240833
SponsorHospital de Clinicas de Porto Alegre
Last Modified on22 March 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Non-elective ICU admission
Severe acute kidney injury (AKI) defined either: A ≥ 2-fold increase in serum creatinine from a known pre-morbid baseline or during the current hospitalization OR Urine output < 6.0 mL/kg over the preceding 12 hours

Exclusion Criteria

Life-threatening indication of RRT (defined as intractable hyperkalaemia, acidosis, uraemic symptoms) at Day 0
RRT before recruitment
Use of Extracorporeal membrane oxygenation (ECMO)
Hepatic cirrhosis or other condition with portal hypertension
Lack of commitment to provide RRT as part of limitation of ongoing life support
Known pre-hospitalization advanced chronic kidney disease, defined by an estimated glomerular filtration rate < 30 mL/min/1.73 m2 or chronic RRT
Refusal to sign the informed consent form
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