Actively Recruiting
Fluid-removal Guided by VeXUS Score With Usual Care in Patients With Acute Kidney Injury After Cardiac Surgery
Led by Hospices Civils de Lyon · Updated on 2025-04-13
40
Participants Needed
2
Research Sites
100 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
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 using the VeXUS score to guide fluid removal in haemodynamically stabilised patients could promote renal recovery after acute kidney injury remains to be investigated. Before designing a large randomised trial to test such a strategy, its feasibility in a pilot randomised trial is assessed.
CONDITIONS
Official Title
Fluid-removal Guided by VeXUS Score With Usual Care in Patients With Acute Kidney Injury After Cardiac Surgery
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Admission to intensive care unit within 72 hours after cardiac surgery with extracorporeal circulation
- Acute kidney injury diagnosed by KDIGO criteria
- Vasoactive inotropic score less than 45
- Capillary refill time less than 3 seconds
- Provided informed written consent
You will not qualify if you...
- Low potassium level below 3.5 mmol/L
- Low sodium level below 125 mmol/L
- High sodium level above 145 mmol/L
- Metabolic alkalosis with pH above 7.50
- Unable to measure capillary refill time
- Chronic liver disease
- Cirrhosis with portal hypertension
- Known blood clot in inferior vena cava
- Mechanical circulatory support like ECMO or single left ventricular assistance
- Severe chronic kidney disease before surgery (GFR below 30 mL/min/1.73m2)
- Expected need for kidney replacement therapy within 24 hours
- Known allergy to Furosemide or hydrochlorothiazide
- Severe wheat allergy
- Currently in another interventional study with ongoing exclusion period
- Pregnant, breastfeeding, or women of childbearing age without proper contraception
- Under legal guardianship or similar protective status
- Under psychiatric care
- Not covered by social security or equivalent insurance
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 2 locations
1
Hôpital Louis Pradel, Groupement Hospitalier Est, Hospices Civils de Lyon
Bron, Bron, France, 69500
Not Yet Recruiting
2
Hopital cardiologique Louis Pradel
Bron, France
Actively Recruiting
Research Team
J
Jean-Luc Fellahi, MD
CONTACT
R
RUSTE Martin, MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
OTHER
Number of Arms
2
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