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The proposed study will evaluate if a standardised dose of furosemide administered in the 12 hours after RRT liberation can predict successful liberation in critically ill patients. The dose that will be administered is in accordance with the prescribing information.
Response to furosemide administration is commonly used in clinical practice to assess a patient's potential for RRT liberation. However, this administration is not standardized and practices varies greatly. Rapid recognition of unsuccessful RRT liberation is crucial to avoid further complications such as fluid overload or acid-base and electrolyte disorders. The FST corresponds to the intravenous administration of 1 mg/kg (1.5 mg/kg in previously exposed patients) of furosemide and the assessment of resulting diuresis in the following two hours. FST is able to predict progression from AKI stage I and II to stage III with a high sensitivity (87.1%) and specificity (84.1%), area under the ROC curve 0.87. However, the ability of FST to predict RRT liberation has never been formally assessed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Critically ill patients undergoing RRT | Patients admitted to participating ICU and receiving renal replacement therapy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Furosemide stress test | Drug | The FST corresponds to the intravenous single-dose administration of 1 mg/kg (1.5 mg/kg in previously exposed patients) of furosemide and the assessment of resulting diuresis in the following two hours. In the 12 hours following the first RRT liberation, a FST will be performed. The test will be considered positive if urinary output is ≥200 mL in the two hours following furosemide administration. |
| Measure | Description | Time Frame |
|---|---|---|
| Successful liberation of RRT within 72 hours after FST | No renal replacement therapy administered | within 72 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Successful liberation of RRT at ICU discharge | No renal replacement therapy administered | At time of ICU discharge, assessed up to 90 days post inclusion |
| Successful liberation of RRT at hospital discharge |
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Inclusion Criteria:
Exclusion Criteria:
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ICU patients receiving continuous RRT for AKI
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| Name | Affiliation | Role |
|---|---|---|
| Antoine Schneider, MD PhD | Centre Hospitalier Universitaire Vaudois | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Universitaire Vaudois | Lausanne | Canton of Vaud | 1011 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24053972 | Result | Chawla LS, Davison DL, Brasha-Mitchell E, Koyner JL, Arthur JM, Shaw AD, Tumlin JA, Trevino SA, Kimmel PL, Seneff MG. Development and standardization of a furosemide stress test to predict the severity of acute kidney injury. Crit Care. 2013 Sep 20;17(5):R207. doi: 10.1186/cc13015. |
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| ID | Term |
|---|---|
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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Urine sample at D0, D1, D2 and D3 and on RRT restart (if applicable)
|
|
No renal replacement therapy administered
| At time of hospital discharge, assessed up to 90 days post inclusion |
| Adverse events associated with the intervention | (electrolyte disturbances, hypotension) | within 6 hours |
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |