Is Myocardial Stunning Induced by Continuous Renal Replacement Therapy a Reality in Critically Ill Patients?

Myocardial Stunning Clinical Trial

— MS-CRRT  

Official title:

Is Myocardial Stunning Induced by Continuous Renal Replacement Therapy a Reality in Critically Ill Patients?

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05209230
• Other study ID #: 69HCL21_1013
• Status: Recruiting
• Phase: N/A
• Start date: April 15, 2022
• Est. completion date: June 16, 2025

Study information

• Verified date: April 2023
• Source: Hospices Civils de Lyon
• Contact: RUSTE Martin, MD, Msc
• Phone: +33472118956
• Email: martin.ruste[@]gmail.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Myocardial stunning during chronic intermittent hemodialysis is a well-described phenomenon. Little case series of patients presenting myocardial stunning during renal replacement therapy for acute kidney injury in critically ill patients are reported, with intermittent hemodialysis and continuous renal replacement therapy. However, the small sample sizes and the absence of a control arm limit their interpretation, mainly whether the myocardial stunning may be related to cardiac loading conditions variations and whether it may impact the hemodynamic. The investigator hypothesize that myocardial stunning induced by renal replacement therapy is frequent, independent from cardiac loading conditions and associated with peripheral hypoperfusion.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 42
• Est. completion date: June 16, 2025
• Est. primary completion date: June 15, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 90 Years

Eligibility

Inclusion Criteria:

• Age > 18 years old
• Acute Kidney Injury grade 3 (KDIGO)
• Indication for renal replacement therapy for the clinician in charge

Exclusion Criteria:

• Emergency indication to renal replacement therapy (pH<7.15, Kaliemia > 6mmol/L, refractory pulmonary oedema)
• Poor echogenicity with speckle tracking analysis failure
• Chronic hemodialysis
• Extra corporeal membrane oxygenation, left ventricular assist device.

Related Conditions & MeSH terms

• Acute Kidney Injury
• Emergencies
• Myocardial Stunning

Intervention

Procedure:
• Continuous renal replacement therapy
Continuous renal replacement therapy (veno venous hemofiltration) without net ultrafiltration, through a dedicated central venous catheter

Other:
• Control group
Continuous renal replacement therapy is differed from 6 hours to allowed 2 control echocardiographic evaluations

Locations

Country	Name	City	State
France	Département d'anesthésie-réanimation Hôpital cardiologique Louis Pradel Groupe Hospitalier Est	Bron
France	Ruste Martin	Bron
France	Hopital Edourd Herriot	Lyon

Sponsors (1)

Lead Sponsor	Collaborator
Hospices Civils de Lyon

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of segment of the left ventricle with regional wall motion abnormalities	Numbers of segments of the left ventricle (by patient) with a decrease greater than 20% of the peak systolic longitudinal strain (2D speckle tracking) on the second echocardiography as compared to baseline.	Change between the echocardiography at baseline and the echocardiography 4 hours after.