Perfusion Parameters and Outcome During a Standardized Deresuscitation Strategy with Net Ultrafiltration: a Retrospective Cohort Study. (DeepCART)

Civil Hospices of Lyon

Status: Completed

Conditions: Acute Kidney Injury; Continuous Renal Replacement Therapy; Fluid Overload

Treatments: Other: Describe the perfusion parameters during a deresuscitation strategy and their association with the outcome.

Study type: Observational

Funder types: Other

Identifiers

NCT06899880

24-5563

Details and patient eligibility

About

Hemodynamic tolerance of fluid removal during deresuscitation is a cornerstone of the impact on outcome of such a strategy. However, how to define and to predict hemodynamic tolerance to fluid removal remains controversial. The investigators routinely use a standardized deresuscitation protocol in patients with fluid overload and continuous renal replacement therapy combined with monitoring of clinical and biological perfusion parameters.

The aim of the study was to describe perfusion during deresuscitation, and to determine whether it is associated with major adverse kidney events at day 30.

Enrollment: 120 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18 years old
• Acute kidney injury requiring continuous renal replacement therapy
• Standardized deresuscitation following a routine care protocol

Exclusion criteria

• Chronic hemodialysis
• Advanced directives to withhold or withdraw life-sustaining treatment,
• Patient's opposition to the use of his/her personal health data

Trial design

120 participants in 1 patient group

Standardized deresuscitation strategy

Description:

Eligible patients without hypoperfusion benefited from: 1) a restrictive approach of intakes combining hypercaloric enteral or per os feeding with hydric restriction as much as possible and no fluid of maintenance, and 2) a systematic UFnet of 2 mL/kg/h until reaching dry weight and a systematic monitoring every 6 h of: peripheral perfusion by capillary refilling time and mottling score, arterial lactate level, and central venous oxygen saturation.

Treatment:

Other: Describe the perfusion parameters during a deresuscitation strategy and their association with the outcome.