Lung Ultrasound-Guided Fluid Deresuscitation in ICU Patients

Launched by ACADEMISCH MEDISCH CENTRUM - UNIVERSITEIT VAN AMSTERDAM (AMC-UVA) · Jan 11, 2022

Keywords

ClinConnect Summary

This clinical trial is studying how using a special imaging tool called lung ultrasound can help doctors better manage excess fluid in the lungs of patients who are on invasive mechanical ventilation in the intensive care unit (ICU). The researchers believe that guiding treatment with lung ultrasound will allow patients to be taken off the ventilator sooner than if doctors rely on their usual methods. The study will involve around 1,000 adult patients who are expected to need help breathing for more than 24 hours after joining the trial.

To participate in this study, patients must be admitted to one of the participating ICUs and have been on a ventilator for less than 24 hours. However, those under 18 years old, pregnant individuals, or patients with certain medical conditions may not be eligible. Participants will be randomly assigned to one of two groups: one group will have their fluid management guided by lung ultrasound, while the other group will follow standard treatment practices. This trial is still recruiting participants, and it aims to see if the ultrasound-guided approach can lead to more days without needing the ventilator.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Admission to one of the participating ICUs;
• • Invasively ventilated for less than 24 hours at randomization;
• • Expected to be under invasive ventilation for longer than 24 hours after randomization.
• Exclusion Criteria:
• • Age below 18 years old;
• • Suspected or confirmed pregnancy;
• • Participation in other interventional trials with similar endpoints;
• • Use of long term home mechanical ventilation;
• • Neurological condition that can prolong duration of mechanical ventilation (i.e.Guillain-Barré syndrome, high spinal cord lesion, amyotrophic lateral sclerosis, multiple sclerosis, or myasthenia gravis);
• • Conditions in which LUS cannot be performed or correctly interpreted (i.e. chest wall abnormalities, morbid obesity, and pre-existing interstitial lung disease);
• • Conditions in which targeting a negative fluid balance is discouraged (i.e. subarachnoid bleeding, severe rhabdomyolysis (CK \> 20.000);
• • Previous participation in this RCT;
• • Patients transferred from another center and invasively ventilated for longer than 24 hours.