Is Myocardial Stunning Induced by Continuous Renal Replacement Therapy a Reality in Critically Ill Patients?

Not Applicable

Recruiting

• Conditions: Acute Kidney Injury KDIGO 3; Continuous Renal Replacement Therapy Initiated by the Clinician in Charge Without Emergency; Myocardial Stunning
• Interventions: Procedure: Continuous renal replacement therapy; Other: Control group

• Registration Number: NCT05209230
• Lead Sponsor: Hospices Civils de Lyon

Brief Summary

Myocardial stunning during chronic intermittent hemodialysis is a well-described phenomenon. Little case series of patients presenting myocardial stunning during renal replacement therapy for acute kidney injury in critically ill patients are reported, with intermittent hemodialysis and continuous renal replacement therapy. However, the small sample sizes and the absence of a control arm limit their interpretation, mainly whether the myocardial stunning may be related to cardiac loading conditions variations and whether it may impact the hemodynamic.

The investigator hypothesize that myocardial stunning induced by renal replacement therapy is frequent, independent from cardiac loading conditions and associated with peripheral hypoperfusion.

Detailed Description

Not available

Basic Information
|
Recruitment & Eligibility
|
Study & Design
|
Trial Locations

Study Timeline

• Study First Submitted: 2022-01-11
• Study First Submitted QC: 2022-01-25
• Study First Posted: 2022-01-26
• Study Start: 2022-04-15
• Status Verified: 2023-04
• Last Update Submitted: 2023-04-18
• Last Update Posted: 2023-04-19
• Primary Completion: 2025-06-15
• Study Completion: 2025-06-16

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 42

Inclusion Criteria

• Age > 18 years old
• Acute Kidney Injury grade 3 (KDIGO)
• Indication for renal replacement therapy for the clinician in charge

Read More

Exclusion Criteria

• Emergency indication to renal replacement therapy (pH<7.15, Kaliemia > 6mmol/L, refractory pulmonary oedema)
• Poor echogenicity with speckle tracking analysis failure
• Chronic hemodialysis
• Extra corporeal membrane oxygenation, left ventricular assist device.

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Continuous renal replacement therapy arm	Continuous renal replacement therapy	Echocardiographic evaluation (with 2D speckle tracking analysis of left ventricular segmental function) 1 hour before and 3 hours after the initiation of continuous renal replacement therapy (continuous veno venous hemofiltration) initiation
Control arm	Control group	Two echocardiographic evaluations (with 2D speckle tracking analysis of left ventricular segmental function) at an interval of 4 hours, before the continuous renal replacement therapy initiation.

Primary Outcome Measures

Name	Time	Method
Number of segment of the left ventricle with regional wall motion abnormalities	Change between the echocardiography at baseline and the echocardiography 4 hours after.	Numbers of segments of the left ventricle (by patient) with a decrease greater than 20% of the peak systolic longitudinal strain (2D speckle tracking) on the second echocardiography as compared to baseline.

Trial Locations

Locations (3)

Département d'anesthésie-réanimation Hôpital cardiologique Louis Pradel Groupe Hospitalier Est; 🇫🇷 Bron, France

Ruste Martin; 🇫🇷 Bron, France

Hopital Edourd Herriot; 🇫🇷 Lyon, France