Guidance of Ultrasound in Intensive Care to Direct Euvolemia: A Cluster Randomized Crossover Comparative Effectiveness Trial (GUIDE Trial)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Kidney Injury
- Sponsor
- The University of Texas Health Science Center, Houston
- Enrollment
- 415
- Locations
- 1
- Primary Endpoint
- Number of Participants Who Receive 3 or More Ultrasound Volume Assessments
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The purpose of this study is to assess the effectiveness of routine ultrasound assessments of volume status and fluid responsiveness for goal-directed therapy (GDT)-based fluid resuscitation in reducing acute kidney injury (AKI) incidence and duration in trauma patients in a teaching institution.
Investigators
Gabrielle Hatton
Research Fellow
The University of Texas Health Science Center, Houston
Eligibility Criteria
Inclusion Criteria
- •Injured patients that are admitted to the trauma ICU
Exclusion Criteria
- •Incarceration
- •Pregnancy
Outcomes
Primary Outcomes
Number of Participants Who Receive 3 or More Ultrasound Volume Assessments
Time Frame: within 24 hours of ICU admission
Number of Acute Kidney Injury (AKI)-Free Days
Time Frame: within 7 days of injury
AKI will be defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria, and all stages will be considered AKI: Stage 1 - Serum Creatinine 1.5-1.9 times baseline or ≥0.3 mg/dL increase Stage 2 - Serum Creatinine 2-2.9 times baseline Stage 3 - Serum Creatinine 3 times baseline or Increase in serum creatinine to ≥4 mg/dL or Initiation of renal replacement therapy
Secondary Outcomes
- Number of Participants With Acute Kidney Injury (AKI)(within the first 7 days of ICU admission)
- Quantity of Fluids Administered(48 hours)
- Quantity of Diuretics Administered(48 hours)
- Time to Lactate Normalization(within the first 7 days of ICU admission)
- Type of Fluids Administered(48 hours)
- Time to Creatinine Concentration <1.5 mg/dL or to Prehospital Baseline(within the first 7 days of ICU admission)
- Number of Participants With Need for Renal Replacement Therapy(within the first 30 days of ICU admission)
- Number of ICU-free Days(within first 30 days after injury)
- Stage of Acute Kidney Injury (AKI)(within the first 7 days of ICU admission)
- Number of Ventilator-free Days(within first 30 days after injury)
- Time to Base Excess Normalization(within the first 7 days of ICU admission)