Intensive Care Clinical Trial
Official title:
A Multi-centre Randomized Controlled Trial of Fluid Resuscitation With Starch (6%Hydroxyethyl Starch 130/0.4) Compared to Saline (0.9% Sodium Chloride) in Intensive Care Patients on Mortality
The aim of this study is to determine whether patients in the Intensive Care Unit who receive fluid resuscitation with either hydroxyethyl starch (a synthetic colloid solution) or saline (a salt solution), have an increased rate of survival at 90 days.
Patients in intensive care units frequently require intravenous fluid because the treating
clinicians consider that the patient's blood pressure or circulating blood volume needs to
be increased to clinically acceptable levels. Despite fluid resuscitation being a
fundamental part of standard medical treatment for critically ill patients, clinicians are
left with uncertainty about the optimal choice and volume of fluid that should be
administered.
This study is a prospective, multi−centre, blinded, randomised controlled trial.
The two fluids being compared are 0.9% sodium chloride (saline) and 6% hydroxyethyl starch
130/0.4 in 0.9% sodium chloride,(starch). The null hypothesis assumes no difference in
all-cause mortality between patients given starch in comparison with patients given saline
for fluid resuscitation.
Each patient who meets all inclusion criteria and none of the exclusion criteria will be
randomised to receive one of the two study fluids for fluid resuscitation.
Once treatment has been assigned the participant will continue to receive either starch or
saline only for all fluid resuscitation requirements in intensive care. The treating
clinical team will decide the amount and frequency of the fluid given for resuscitation
based on standard care.
During their ICU stay, participants will have information on the use of study fluids, other
fluids, kidney function, blood pressure, heart rate and other haemodynamic data that is
routinely recorded in the medical record collected. All participants will be followed up at
day 90 and at 6 months after randomisation.
The participants status (alive, in hospital and length of stay) will be recorded at day 28
and day 90 after randomisation. At the 6 month follow−up all participants or their carer
will be interviewed by telephone using standardised questionnaires about the participant's
quality of life. In addition, participants who were admitted to intensive care with a
traumatic brain injury will be interviewed to determine how well the participant is
recovering.
After all patients have completed the 6 months of follow−up, data linkage will also be used
to link patients (in NSW only) to health databases in order to obtain information on their
use of health services.
;
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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