Critical Illness Clinical Trial
Official title:
Forced Fluid Removal vs. Usual Intensive Care in High-risk Acute Kidney Injury With Severe Fluid Overload - A Randomized Controlled Trial
The objective of this pilot trial is to assess the feasibility of forced fluid removal in patients admitted to the intensive care unit (ICU) with high-risk AKI and severe fluid overload. The intervention will use furosemide infusion and/or continuous renal replacement therapy (CRRT) to achieve and maintain a neutral cumulative fluid balance. The intervention will be compared to standard of care as reflected in the kidney disease improving global outcome (KDIGO) guidelines.
Acute kidney injury (AKI) is a common and serious complication in patients admitted to ICU. A
core element of critical care is resuscitation with crystalloid solutions. In many cases
fluid accumulates and patients become fluid overloaded (positive fluid balance > 10% of
bodyweight). This is especially true in patients with AKI, since they often have impaired
ability to excrete salt and water. Most observational suggests harm with increased positive
fluid balance.
Objectives: To assess feasibility of forced fluid removal with diuretics and/or CRRT in ICU
patients with AKI and severe fluid overload, compared to current clinical practice.
Design: Multicentre, parallel group, randomized, assessor blinded pilot-trial with adequate
generation of allocation sequence, and allocation concealment.
Trial Size: The pilot study is planned to include 50 patients. Inclusion is expected to start
in August 2015.
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