Role of Active Deresuscitation After Resuscitation:

Launched by UNITY HEALTH TORONTO · Mar 16, 2024

Keywords

ClinConnect Summary

The RADAR-Canada trial is a research study designed to explore a new approach called "deresuscitation" for patients who have received too much fluid during their stay in the intensive care unit (ICU). This trial aims to see how well patients accept this treatment, how closely they follow the plan, and what effects it has on their health. It focuses on individuals who have been on a breathing machine for more than 48 hours and have accumulated more than 3 liters of extra fluid or have noticeable swelling in their arms, legs, or body.

To be eligible for this trial, participants must be at least 18 years old and have been in the ICU for five days or less. They should not be experiencing severe bleeding, unstable blood pressure, or certain other serious conditions. If someone decides to participate, they will receive the new treatment aimed at removing excess fluid and will be monitored closely to see how they respond. It's important to note that this trial is still in the planning stage and has not started recruiting participants yet.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Age 18 years or older
• • 2. Mechanically ventilated for \> 48 hours
• • 3. Calculated volume accumulation \> 3 liters since ICU admission or pitting edema in at least two sites (arms, legs, or trunk)
• • 4. Admitted to ICU for ≤ five days
• • 5. Informed consent obtained from patient or alternate decision-maker
• Exclusion Criteria:
• • 1. Lack of consent from patient or substitute decision maker or from responsible physician 2. Active bleeding (defined as \> 2 units transfused RBC in past 24 hours) 3. Hemodynamic instability (defined as use of vasopressors \>0.1 µg/kg/minute norepinephrine or equivalent, or increase in vasopressor dose over past 6 hours) 4. Currently receiving dialysis, or plans to initiate dialysis imminently 5. P/F ratio \< 75 6. Subarachnoid hemorrhage 7. Severe traumatic brain injury with admission GCS \<8 8. Diabetic ketoacidosis or hyperosmolar state 9. Acute cardiac failure or cardiogenic shock 10. Suspected or established diabetes insipidus 11. Allergy to furosemide 12. High probability of death within 24 hours
• • -