Acute Kidney Injury Clinical Trial
— TECHNO-HDFOfficial title:
Non-invasive Assessment to Predict Tolerance to Fluid Removal on Intermittent Kidney Replacement Therapy
This prospective cohort study aim to investigate the ability of multiple types of assessments including 1) the modified Venous Excess Ultrasound (VExUS) assessment, 2) non-invasive estimation of absolute blood volume (ABV), and 3) change in carotid Doppler at the start of IKRT to predict IDHE in acutely ill hospitalized patients. The secondary aim will be to determine whether each modality improves the prediction of IHDE compared to the evaluation of the attending physician and whether they also predict cerebral hypoxia during IKRT measured by near-infrared spectroscopy (NIRS). Finally, detailed hemodynamic data including relative blood volume monitoring, tissue oximetry, and other parameters will be collected continuously during IKRT sessions enabling exploratory analyses aimed at identifying hemodynamic phenotypes related to IDHE during IKRT.
Status | Recruiting |
Enrollment | 75 |
Est. completion date | April 1, 2024 |
Est. primary completion date | February 1, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: 1. Adult patient =18 year-old 2. Hospitalized at the CHUM in the intensive care unit (ICU) or general ward 3. Receiving or planned =3x/week IKRT treatments 4. Planned on-line hemodiafiltration (HDF) or hemodialysis (HD) sessions with =1L of fluid removal per session Exclusion Criteria: 1. Planned hospital discharge, death, or transition to comfort care within 48 hours according to the attending physician 2. End of active care (awaiting hospital discharge) |
Country | Name | City | State |
---|---|---|---|
Canada | Centre Hospitalier de l'Université de Montréal | Montreal | Quebec |
Lead Sponsor | Collaborator |
---|---|
Centre hospitalier de l'Université de Montréal (CHUM) | The Kidney Foundation of Canada |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Intradialytic hypotensive event in the peri-dialytic or post-dialytic period | Intradialytic hypotension will be defined as a drop in systolic blood pressure below 90 mmHg which requires an intervention (dialysis interruption, vasopressor initiation or dosage increase, fluid bolus, interruption of net ultrafiltration, change in body position with therapeutic intent) In patients with a baseline below 90 mmHg, it will be defined as a decrease of more than 10 mmHg from baseline systolic blood pressure. | From the initiation of dialysis to 15 minutes after dialysis | |
Secondary | Intradialytic cerebral desaturation events | >15% decrease in cerebral oximetry (NIRS) measurements relative to baseline value. | From the initiation of dialysis to 15 minutes after dialysis | |
Secondary | Rate of intradialytic hypotension | The proportion of sessions with at least one episode of intradialytic hypotension (as previously defined) within 14 days from enrollment | From enrolment to 14 days | |
Secondary | Mortality rate | All cause mortality | From enrolment to 90 days |
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