Improving Care for Critically Ill Children at High Risk of Acute Kidney Injury Using a Clinical Decision Support Tool with the Furosemide Stress Test

What this Trial Is About

Researchers are investigating whether adding a clinical decision support tool to the electronic medical record can help clinicians use the furosemide stress test FST more effectively in critically ill children at high risk for severe acute kidney injury AKI. The study aims to determine if this tool reduces fluid overload and better predicts which children will need dialysis by comparing patient outcomes before and after the tools implementation. The intervention involves developing and implementing a clinical decision support strategy integrated into routine care in the pediatric intensive care unit PICU. This tool uses risk stratification and biomarker testing, including the Renal Angina Index RAI and urine neutrophil gelatinase-associated lipocalin NGAL, to identify patients at high risk for severe AKI and standardize the use of FST. Patients identified after the tools introduction will be compared to those before its use over two years. Participants admitted to the PICU who meet risk criteria will be followed for two years after the tool is implemented, with researchers collecting data on fluid accumulation, ICU free days, use of continuous renal replacement therapy CRRT, and blood pressure support needs after FST. The study will assess how acceptable and feasible the decision support tool is for clinicians, monitor patient outcomes, and evaluate the predictive value of urine flow rate after the FST for CRRT use.

FST Analysis Supporting Timely Therapy and Risk Assessment Via Clinical Decision Support for Kids