An observational study of relative hypotension and risk of acute kidney injury among critically ill patients with shock

Not Applicable

Completed

• Conditions: Critically ill patients with shock; Acute kidney injury; Relative hypotension; Cardiovascular - Other cardiovascular diseases

• Registration Number: ACTRN12613001368729
• Lead Sponsor: John Hunter Hospital

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2013-12-13
• Last Update Posted: 13 January 2020

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 300

Inclusion Criteria

a. ICU patients aged at least 40 yrs
b. Trauma is not the main reason for the current ICU admission
c. The patient is within 48 hours of ICU admission
d. Patient has a central venous catheter (CVC) in situ or the
placement of a CVC is imminent (within the next hour) as part of routine ICU management.
e. The patient is receiving positive pressure ventilation (PPV) or the treating clinician anticipates the need for PPV (includes invasive or non-invasive ventilation or the use of high-flow oxygen)
f. Shock, defined as clinician-initiated vasopressor therapy for at least 4 hours or more AND supported by any of the following within last 24 hours:
1) Lactate > or =2 mmol/l, or base deficit > or =3 mmol/l,
2) Central venous oxygen saturation (ScvO2) < or =60%
3) Creatinine increase by >44 micromol/l
4) Urine output <0.5 ml/kg/h or <40 ml/h for 2 hours

Exclusion Criteria

a.Patients who are moribund, or deemed to have life expectancy of less than 6 months.
b.Patients with renal failure requiring RRT, or in imminent need of RRT within the next 12 hours in the opinion of treating clinician or increase in serum creatinine of >350 micromol/l
c.End stage renal disease
d.Patients on extracorporeal support (ECMO, IABP, VAD).
e.Patient has already been included in the study.
f.Pregnancy, if known
g.Active bleeding (clinical suspicion or requiring 3 or more packed red blood cells within 24 hours)
h.Potential contraindications to either higher or lower BP targets (including but not limited to)
1)Cerebral perfusion pressure guided therapy e.g. intracranial hemorrhage or subarachnoid hemorrhage or traumatic brain injury
2)Abdominal perfusion pressure guided therapy
3)Aortic injury (e.g. dissection or post-operative)
4)Post cardiac surgery
5)Any other condition requiring higher or lower BP target specifically

Study & Design

• Study Type: Observational
• Study Design: Not specified