Hemodynamic Effects of Blood Flow Variation in Continuous Renal Replacement Therapy

Saint Louis University (SLU)

Status: Terminated

Conditions: Acute Kidney Injury; End-stage Renal Disease

Treatments: Device: continuous renal replacement therapy using System One (TM) setup (Nxstage)

Study type: Interventional

Funder types: Other

Identifiers

NCT03078504

26817

Details and patient eligibility

About

Purpose of this study is to evaluate the short-term hemodynamic effects of changes in blood flow rates in critically ill patients receiving continuous renal replacement therapy.

Enrollment: 6 patients

Sex: All

Ages: 18 to 89 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18-89
• Acute renal failure or end-stage renal disease necessitating CRRT
• Admitted to the MICU service
• If on vasopressor/inotropic agent, norepinephrine as only intravenous pressor
• If on vasopressor/inotropic agent, at stable pressor dose for at least four hours
• If on IV fluids, stable dose of crystalloids <= 100cc/hour and is not receiving colloids for 4 hours or more prior to initiation of CRRT
• Mean arterial pressure (MAP) >= 65
• Arterial catheter present for continuous blood pressure monitoring
• CRRT duration of 48 hours or less using NxStage System One dialysis system
• successfully tolerated CRRT for at least 4 hours without clotting or hemodynamic instability
• no other procedures, blood products transfusion, or additional medication administration are anticipated during the study period

Exclusion criteria

• listed for organ transplant
• atrial fibrillation, other irregular heart rhythm, unstable arrhythmia
• need for more than one intravenous vasopressor agent
• intravenous vasopressor/inotropic agent other than norepinephrine (ie dobutamine, dopamine, vasopressin, epinephrine)
• therapeutic anticoagulation being administered
• known acute myocardial infarction as defined by elevated troponin along with a documented clinical diagnosis during current hospitalization
• known acute stroke, intracerebral hemorrhage, intracranial mass effect, or elevated intracranial pressure within the last 30 days.
• dialysis catheter malfunction and unable to maintain target blood flow rate
• fluid removal (ultrafiltration) rate > 100mL/hour

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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6 participants in 1 patient group

Experimental arm

Experimental group

Description:

The patients will have the blood flow rate adjusted on CRRT gradually increased to assess the effect on hemodynamics

Treatment:

Device: continuous renal replacement therapy using System One (TM) setup (Nxstage)