Optimization of Fluid Balance Guided by Bioelectrical Impedance Analysis in Patients Undergoing Continuous Renal Replacement Therapy in Critical Care

Launched by CENTRE HOSPITALIER UNIVERSITAIRE, AMIENS · Jan 28, 2025

Keywords

ClinConnect Summary

This clinical trial is studying how to manage fluid balance in critically ill patients who require a specific type of kidney treatment called continuous renal replacement therapy (CRRT). The goal is to find out if using a special measurement technique, called bioelectrical impedance analysis (BIA), to guide fluid removal can improve patient outcomes. In the trial, participants will be divided into two groups: one group will have their fluid removal guided by their doctor based on their overall condition, while the other group will use the BIA measurements to help make those decisions. The researchers want to see if the BIA approach helps reduce excess fluid more effectively over a 72-hour treatment period.

To be eligible for this trial, participants must be over 18 years old and currently hospitalized in the intensive care unit at Amiens-Picardie University Hospital. They should have a significant increase in fluid levels and be receiving CRRT due to specific health issues, like kidney failure or high potassium levels. Participants will need to provide consent to join the study, either themselves or through a family member if they are unable to do so. If you or a loved one is considering participating, it’s important to know that this study aims to improve the treatment of fluid overload, which can be life-threatening, and may provide valuable insights into better care for critically ill patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age \> 18 years
• • The patient was hospitalized in the intensive care unit of Amiens-Picardie University Hospital.
• • Patient with an increase in fluid balance (TBW \> 5%)
• • Patient receiving continuous veno-venous hemofiltration (CVVH) on a PrismaFlexR or PrisMaxR machine, initiated due to oliguria, potassium level \> 6.5 mmol/L, urea level \> 25 mmol/L, or creatinine \> 300 µmol/L and severe metabolic acidosis (pH \< 7.2).
• • Hemodynamically stable patient with a mean arterial pressure (MAP) \> 65 mmHg for more than 4 hours with norepinephrine.
• • Signed consent to participate in the study by the patient or, if unconscious, their legal representative/next of kin.
• Exclusion Criteria:
• • Invalid BIA measurements
• • Internal device powered by an electrical current (pacemaker, implantable cardioverter-defibrillator, neurostimulator)
• • Cardiac arrhythmia (atrial fibrillation, atrial flutter) present at the inclusion
• • Chronic dialysis patient
• • Moribund patient
• • The patient is on extracorporeal mechanical support
• • Hemorrhagic shock
• • Pregnant woman
• • Patient under guardianship or conservators.