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Fluid-removal Guided by VeXUS Score With Usual Care in Patients With Acute Kidney Injury After Cardiac Surgery

RecruitingNAAges 18 Years - 85 YearsAllHospices Civils de Lyon
NCT06251713 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Acute kidney injury affects more than 30% of patients after cardiac surgery, and is associated with an excess in mortality. There is a clinical continuum between acute kidney injury (transient if \<48h, persistent if \>48h), the development of acute kidney and chronic renal failure. Each of these entities characterising renal recovery is associated with an increase in long-term morbidity and mortality. Fluid management in patients with acute kidney injury is challenging, as both hypovolaemia and hypervolaemia are detrimental. Venous congestion (reflecting intravascular hypervolaemia), is a well-established haemodynamic factor contributing to acute kidney injury after cardiac surgery. An ultrasound score, based on the venous doppler pattern explored in intra-abdominal organs, has recently been developed and is a better predictor of acute kidney injury than central venous pressure. Whether

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📋 Eligibility rules (as published)
Inclusion Criteria: * Intensive care unit admission within 72 hours of cardiac surgery with extracorporeal circulation * Acute kidney injury defined by KDIGO criteria * Vasoactive inotropic score \<45 and capillary refill time \<3s * Informed written consent Exclusion Criteria: * Hypokalaemia \<3.5mmol/L * Hyponatremia\<125mmol/L * Hypernatremia \>145mmol/L * Metabolic alkalosis with pH \>7.50 * Impossibility to measure capillary refill time * Chronic liver disease * Cirrhosis with portal hypertension * Known thrombus of the inferior vena cava * Mechanical circulatory assistance (ECMO or mono left ventricular assistance) * Severe pre-operative chronic kidney disease (GFR \< 30mL/min/1.73m2) * Need for renal replacement therapy anticipated by the attending physician within 24 hours * Known hypersensitivity to Furosemide and/or hydrochlorothiazide * Severe allergy to wheat * Patient already included in another interventional study with an exclusion period still in progress * Pregnant, breast-feeding or women of childbearing age without suitable contraception * Patients under guardianship, curatorship or safeguard of justice * Patients under psychiatric care * Patients not affiliated to a social security scheme or beneficiaries of a similar scheme
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What it tests

  • VeXUS score guided fluid management strategy
  • Usual care
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Where

2 sites
Hôpital Louis Pradel, Groupement Hospitalier Est, Hospices Civils de Lyon
Bron, France
Hopital cardiologique Louis Pradel
Bron, France
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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