Using a Hypotension Prediction Index to Prevent Low Blood Pressure During Dialysis in ICU Patients (HyPIR-ICU)

Chulalongkorn University

Status: Enrolling

Conditions: Hemodialysis Patients; Intensive Care Unit ICU; Intradialytic Hypotension

Treatments: Device: Standard of care monitoring; Device: Hypotensive prediction index

Study type: Interventional

Funder types: Other

Identifiers

NCT07179705

0204/68

Details and patient eligibility

About

This single-center, crossover randomized controlled trial (HyPIR-ICU) investigates whether a Hypotension Prediction Index (HPI)-guided management strategy can reduce intradialytic hypotension (IDH) during prolonged intermittent renal replacement therapy (PIRRT) in critically ill patients. All participants must have an indwelling arterial catheter for continuous hemodynamic monitoring.

Full description

This study explores whether HPI-guided management during PIRRT can randomization: Block randomization stratified by kidney status (AKI vs. ESKD) and vasopressor use. All parameters are monitored in real-time via the HemosphereⓇ system and reassessed after each intervention.

Enrollment: 46 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults >18 years old
• Diagnosed with acute kidney injury (AKI) or end-stage kidney disease (ESKD)
• Admitted to medical ICU
• Scheduled for PIRRT
• Have an indwelling arterial catheter

Exclusion criteria

• Severe right heart dysfunction, significant valvular disease, arrhythmias, mechanical circulatory support, absence of arterial access, no UF prescription, palliative care, or expected ICU stay <72 hours.

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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46 participants in 2 patient groups

HPI first

Experimental group

Description:

Arm A: HPI-guided management during first PIRRT → standard care in second session

Treatment:

Device: Hypotensive prediction index

Standard of care first

Experimental group

Description:

Arm B: Standard care during first PIRRT → HPI-guided management in second session

Treatment:

Device: Standard of care monitoring