FURosemide Stress Test to Predict Need of Renal Replacement THERapy in Ischemic Acute Tubular Necrosis in ICU

Launched by ASSISTANCE PUBLIQUE - HÔPITAUX DE PARIS · Nov 2, 2018

Keywords

ClinConnect Summary

FURTHER will enroll consecutive patients with AKI KDIGO stage 1 or 2 associated with a sepsis or following a cardiac surgery with CPB within 72h. Patients must have achieved a hemodynamic stabilization confirmed by clinical (no need for intravenous fluids, no significant variation of noradrenaline) and non-clinical (trans-thoracic echocardiography, passive leg rise or other validated tool) assessment. Included patients will receive 1 to 1.5 mg/kg of FUROSEMIDE. Urine output will be measured for 6 hours and compensated by the same volume of intravenous crystalloids. Need for RRT will be asse...

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Eligibility criteria

• Inclusion Criteria:
• • Age over 18 years old
• • Hospitalized in ICU at day of inclusion
• • Diagnosis of sepsis defined as proven or suspected infection and increase of the SOFA (Sequential Organ Failure Assessment) score by 2 points or more compared to basal OR Cardiothoracic surgery with CBP (Cardiopulmonary bypass) within 72 hours before inclusion
• • Adequate cardiac output and volemia assessed by cardiac ultrasound, venous saturation in Oxygen (ScVO2) or ΔPP
• • Hemodynamic stabilization : stable norepinephrine dosage (or \<20% variations) with no vascular filling during the last 3 hours
• • AKI stage I or II in KDIGO classification
• Exclusion Criteria:
• • Chronic Kidney Disease with glomerular filtration rate ≤ 30 ml/mn/1,73m2
• • Obstructive AKI
• • AKI stage III in KDIGO classification
• • Known allergy to loop diuretics
• • Contraindications to Furosemide
• • FST not feasible within 12 hours of eligibility
• • Previous AKI during the same hospitalization
• • Pregnancy or breastfeeding women
• • Subject under a legal protective measure
• • No affiliation to a social regime or CMU