Shock Clinical Trial
Official title:
Pilot Randomised Controlled Study Comparing The Effect of High Cut-off Point Haemofiltration With Standard Haemofiltration In Patients With Acute Renal Failure
This trial aims to study the effect of combining continuous and a new polyamide membrane with larger pores in the treatment of critically ill patients with acute renal failure and low blood pressure (shock) requiring noradrenaline. The investigators wish to compare the clinical effect of this new therapy to that of haemofiltration with a standard membrane.
During acute renal failure, small and middle molecular-weight toxins accumulate. These
molecules are difficult to remove by standard haemofiltration. Accordingly, they accumulate
and contribute to morbidity in long-term dialysis patients. Molecules such as cytokines have
been shown to play a central pathogenic role in critical illness. In critically ill acute
renal failure patients, they accumulate in serum and likely contribute to much morbidity
(fever, low blood pressure, myocardial dysfunction, renal failure itself etc.) Therefore,
the removal of cytokines appears desirable. Although different approaches have been
undertaken, all have had limited success due to complexity, limited efficacy or uncertain
clinical response [10-15].
It is possible that in using a different and more porous membrane, the removal of cytokines
would be much more efficient and that clinical benefits of blood purification would,
therefore, be greater.
A membrane of this kind is now available. It is a modification (moderate increase in pore
size) of another standard material called polyamide, which has already been used in millions
of people for dialysis and haemofiltration. The increased pore size of these new membranes
is directed at a more effective removal of middle molecular-weight toxins such as cytokines.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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