Fluid-removal Guided by VeXUS Score With Usual Care in Patients With Acute Kidney Injury After Cardiac Surgery

Launched by HOSPICES CIVILS DE LYON · Feb 1, 2024

Keywords

ClinConnect Summary

This clinical trial is studying a new way to manage fluid levels in patients who develop acute kidney injury after cardiac surgery. Acute kidney injury is a common problem that can occur in more than 30% of these patients and can lead to serious health issues. The trial is looking at a tool called the VeXUS score, which uses ultrasound to assess blood flow in the body. Researchers want to see if using this score to guide how much fluid is removed can help improve kidney recovery in patients who are stable after surgery.

To participate in this trial, individuals need to be admitted to the intensive care unit within 72 hours of having cardiac surgery, and they must meet specific criteria for acute kidney injury. Key requirements include having a certain score that indicates they are stable and providing informed written consent. Participants will be monitored closely, and their fluid management will be guided by the VeXUS score. This trial is currently recruiting patients and aims to gather important information that could lead to larger studies in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Intensive care unit admission within 72 hours of cardiac surgery with extracorporeal circulation
• • Acute kidney injury defined by KDIGO criteria
• • Vasoactive inotropic score \<45 and capillary refill time \<3s
• • Informed written consent
• Exclusion Criteria:
• • Hypokalaemia \<3.5mmol/L
• • Hyponatremia\<125mmol/L
• • Hypernatremia \>145mmol/L
• • Metabolic alkalosis with pH \>7.50
• • Impossibility to measure capillary refill time
• • Chronic liver disease
• • Cirrhosis with portal hypertension
• • Known thrombus of the inferior vena cava
• • Mechanical circulatory assistance (ECMO or mono left ventricular assistance)
• • Severe pre-operative chronic kidney disease (GFR \< 30mL/min/1.73m2)
• • Need for renal replacement therapy anticipated by the attending physician within 24 hours
• • Known hypersensitivity to Furosemide and/or hydrochlorothiazide
• • Severe allergy to wheat
• • Patient already included in another interventional study with an exclusion period still in progress
• • Pregnant, breast-feeding or women of childbearing age without suitable contraception
• • Patients under guardianship, curatorship or safeguard of justice
• • Patients under psychiatric care
• • Patients not affiliated to a social security scheme or beneficiaries of a similar scheme