Studying Autonomic Nervous System Changes Using Analgesia Nociception Index During Continuous Renal Replacement Therapy in Critically Ill Adults

What this Trial Is About

Researchers are studying the Analgesia Nociception Index ANI, which reflects the balance between the sympathetic and parasympathetic nervous systems by analyzing variations in heart rate intervals. This study focuses on patients undergoing continuous renal replacement therapy CRRT who experience fluid overload and receive net ultrafiltration. The goal is to investigate how ANI changes during fluid removal and how these changes relate to hemodynamic variations caused by the autonomic nervous system. Participants will be monitored during the first six hours after starting net ultrafiltration at a rate of 2-3 milliliters per kilogram per hour. Continuous monitoring includes measuring R-R interval, ANI, cardiac index, invasive arterial pressure, central venous pressure, and peripheral perfusion index. Additional perfusion assessments such as arterial lactate, central venous oxygen saturation, capillary refill time, and mottling score will be performed every six hours. The PhysioDoloris monitor will be attached to the patients scope to record ANI and related parameters continuously throughout the study. During participation, patients will be closely observed in the intensive care unit with invasive blood pressure and central venous line monitoring. Data collection will focus on the percentage change in ANI six hours after starting net ultrafiltration. The study aims to correlate these autonomic nervous system measurements with hemodynamic changes. The total monitoring period is six hours after initiation of the fluid removal process, providing detailed insight into how the autonomic system responds to therapy in critically ill patients.

Analgesia Nociception Index to Explore Autonomic Nervous System in Patients With Continuous Renal Replacement Therapy