Improving Fluid Removal Using Bioelectrical Impedance Analysis During Continuous Kidney Support in Intensive Care

What this Trial Is About

Researchers are studying patients in critical care who require continuous renal replacement therapy CRRT to manage fluid overload. The study aims to evaluate whether using bioelectrical impedance analysis BIA to guide fluid removal improves the reduction of total body water TBW compared to standard care. Excess fluid can cause organ problems and raise the risk of death, so finding the right fluid removal method is important. This is a pilot, randomized, controlled, open-label study comparing two approaches to fluid removal during a 72-hour CRRT period. Participants are randomly assigned to one of two groups. In the standard group, fluid removal rates are set by the physician based on clinical and hemodynamic assessments. In the experimental group, fluid removal is guided by the extracellular to total body water ratio ECWTBWat measured by BIA, aiming to keep this ratio below 0.400 during treatment. Measurements are taken with specialized devices to calculate the ratio, and the physician adjusts fluid removal accordingly. This process continues throughout the 72-hour CRRT session. During the study, patients will receive CRRT and have their fluid balance monitored closely. Researchers will assess total body water levels, fluid removal rates, and various clinical parameters such as blood pressure stability, arrhythmias, and blood chemistry at multiple time points up to 72 hours. Outcomes like filter use, norepinephrine dosage, ventilation duration, mortality, and hospital stay length will also be recorded. Patient safety and fluid status will be carefully tracked to compare the two fluid removal strategies over the treatment period.

Optimization of Fluid Balance Guided by Bioelectrical Impedance Analysis in Patients Undergoing Continuous Renal Replacement Therapy in Critical Care