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| Name | Class |
|---|---|
| Stuivenberg Hospital Antwerp | UNKNOWN |
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Intra- abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are a cause of organ dysfunction in critically ill patients. IAH develops due to abdominal lesions (primary IAH) or extra-abdominal processes (secondary IAH). Secondary IAH arises due to decreased abdominal wall compliance and gut edema caused by capillary leak and excessive fluid resuscitation. Decreasing intra-abdominal pressure (IAP) using decompressieve laparotomy has been shown to improve organ dysfunction. However, laparotomy is generally avoided in patients with secondary IAH due to the risk of abdominal complications.
Acute kidney injury (AKI) is one of the first and most pronounced organ failures associated with IAH and many patients with AKI in the ICU require renal replacement therapy (RRT). Fluid removal using continuous RRT (CRRT) has been demonstrated to decrease IAP in small series and selected patients.
The aim of this study is to evaluate whether fluid removal using CVVH in patients with IAH, fluid overload and AKI is feasible and whether it has a beneficial effect on organ dysfunction (compared to CVVH without net fluid removal).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CVVH with fluid removal | Experimental |
| |
| CVVH without fluid removal | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CVVH | Procedure | CVVH is started using following parameters:
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in IAP in patients receiving fluid removal during CVVH vs patients receiving CVVH without net fluid removal after 24 and 48h of CVVH treatment | 24 and 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Difference between CVVH with fluid removal and CVVH without fluid removal | Difference in terms of
|
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Eric Hoste, MD, Phd | University Hospital Ghent, Belgium | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ZNA Stuivenberg Hospital | Antwerp | Belgium | ||||
| University Hospital Ghent |
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| Label | URL |
|---|---|
| website of the University Hospital Ghent | View source |
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|
| ultrafiltration | Procedure | ultra filtration is started at 100 mL/h and increased according to following protocol
|
|
| ultrafiltration control group | Procedure | ultrafiltration is set at 100 mL/h (and fluid administration is titrated to approach 100 mL /h) |
|
| after 24 hours and/or 7 days |
| Difference between both groups in terms of daily fluid balance | during 7 days |
| The relationship between cumulative fluid balance at the start of each day of CVVH and the fluid balance achieved after 24h of CVVH with fluid removal | 24 hours |
| Difference between both groups regarding recovery of renal function, need for RRT at discharge from the ICU and from the hospital | discharge from ICU and hospital |
| Difference between both groups regarding mortality (28d, ICU and hospital) and ICU and hospital length of stay | 28 days and length of stay in ICU and hospital |
| Ghent |
| Belgium |
| ID | Term |
|---|---|
| D016638 | Critical Illness |
| D059325 | Intra-Abdominal Hypertension |
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003161 | Compartment Syndromes |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| D014462 | Ultrafiltration |
| ID | Term |
|---|---|
| D005112 | Extracorporeal Circulation |
| D013514 | Surgical Procedures, Operative |
| D005374 | Filtration |
| D002623 | Chemistry Techniques, Analytical |
| D008919 | Investigative Techniques |
| D055585 | Physical Phenomena |
| D055598 | Chemical Phenomena |
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