Metabolism of Isotonic Versus Hypotonic Maintenance Solutions in Fasting Healthy Adults

NCT ID: NCT02822898

Last Updated: 2016-08-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2016-08-31

Brief Summary

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The prescription of intravenous maintenance solutions - although widespread - lacks important data on the optimal sodium and potassium content, which has given rise to an important debate in the scientific literature. Our study compares two different infusion fluids in 12 healthy adult volunteers without renal failure in a single-blind randomized crossover design over two 48 hour periods during which subjects are not allowed to eat or drink. Fluid 1 is a premixed solution containing 54 mmol/L of sodium and 26 mmol/L of potassium; fluid 2 is sodium chloride 0.9% in glucose 5% with 40 mmol/L of potassium. Both solutions are administered at 25 mL/kg of ideal body weight, as recommended by current guidelines (NICE 174) and both solutions are widely used in daily clinical practice. The primary hypothesis is that isotonic maintenance solutions lead to more fluid retention than hypotonic fluids. Metabolism of both solutions is assessed by sequential analysis of urine and serum, clinical parameters and bioelectrical impedance analysis.

Detailed Description

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Conditions

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Healthy Adult Volunteers

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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Isotonic Maintenance Fluid

Isotonic Maintenance Fluid

Group Type ACTIVE_COMPARATOR

NaCl 0.9% in Glucose 5% with 40mEq Potassium

Intervention Type DRUG

NaCl 0.9% in Glucose 5% with 40mEq Potassium, administered at 25 mL/kg IBW/h for 48h

Hypotonic Maintenance Fluid

Hypotonic Maintenance Fluid

Group Type ACTIVE_COMPARATOR

Glucion 5%

Intervention Type DRUG

Glucion 5% (premixed solution containing 54 mmol/L sodium and 26 mmol/L potassium amongst others), administered at 25 mL/kg IBW/h for 48h

Interventions

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NaCl 0.9% in Glucose 5% with 40mEq Potassium

NaCl 0.9% in Glucose 5% with 40mEq Potassium, administered at 25 mL/kg IBW/h for 48h

Intervention Type DRUG

Glucion 5%

Glucion 5% (premixed solution containing 54 mmol/L sodium and 26 mmol/L potassium amongst others), administered at 25 mL/kg IBW/h for 48h

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Healthy adults, 18-70 years of age
* BMI 17-45 kg/m².
* Creatinine clearance \>60 ml/min (according to eGFR CKD-EPI formula).

Exclusion Criteria

* Acute medical illness within 3 weeks of first study period
* Chronic medication: under diuretic therapy or other chronic medication that interfere with urine output or induce urine retention. All chronic medication should be declared before being enrolled in the study.
* Medical history:

* cardiac failure,
* malnourishment,
* diabetes mellitus,
* urological disease preventing spontaneous or complete emptying of the bladder,
* any medical or non-medical issue preventing complaint-free fasting for 48 hours (e.g. active peptic ulcer, psychosis, substance abuse…)
* Pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Baxter Healthcare Corporation

INDUSTRY

Sponsor Role collaborator

University Hospital, Antwerp

OTHER

Sponsor Role lead

Responsible Party

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Niels Van Regenmortel

Senior Consultant

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Niels Van Regenmortel, M.D.

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Antwerp

Locations

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University Hospital, Antwerp

Edegem, , Belgium

Site Status

Countries

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Belgium

References

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Lobo DN, Bostock KA, Neal KR, Perkins AC, Rowlands BJ, Allison SP. Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial. Lancet. 2002 May 25;359(9320):1812-8. doi: 10.1016/S0140-6736(02)08711-1.

Reference Type BACKGROUND
PMID: 12044376 (View on PubMed)

Moritz ML, Ayus JC. Maintenance Intravenous Fluids in Acutely Ill Patients. N Engl J Med. 2015 Oct;373(14):1350-60. doi: 10.1056/NEJMra1412877. No abstract available.

Reference Type BACKGROUND
PMID: 26422725 (View on PubMed)

Van Regenmortel N, De Weerdt T, Van Craenenbroeck AH, Roelant E, Verbrugghe W, Dams K, Malbrain MLNG, Van den Wyngaert T, Jorens PG. Effect of isotonic versus hypotonic maintenance fluid therapy on urine output, fluid balance, and electrolyte homeostasis: a crossover study in fasting adult volunteers. Br J Anaesth. 2017 Jun 1;118(6):892-900. doi: 10.1093/bja/aex118.

Reference Type DERIVED
PMID: 28520883 (View on PubMed)

Related Links

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http://guidance.nice.org.uk/CG174

NICE guideline on Intravenous Fluid Therapy in Adults in Hospital

Other Identifiers

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16/15/175

Identifier Type: -

Identifier Source: org_study_id

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