Is Myocardial Stunning Induced by Continuous Renal Replacement Therapy a Reality in Critically Ill Patients?

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

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-15

Study Completion Date

2025-12-18

Brief Summary

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Myocardial stunning during chronic intermittent hemodialysis is a well-described phenomenon. Little case series of patients presenting myocardial stunning during renal replacement therapy for acute kidney injury in critically ill patients are reported, with intermittent hemodialysis and continuous renal replacement therapy. However, the small sample sizes and the absence of a control arm limit their interpretation, mainly whether the myocardial stunning may be related to cardiac loading conditions variations and whether it may impact the hemodynamic.

The investigator hypothesize that myocardial stunning induced by renal replacement therapy is frequent, independent from cardiac loading conditions and associated with peripheral hypoperfusion.

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Detailed Description

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Conditions

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Acute Kidney Injury KDIGO 3 Continuous Renal Replacement Therapy Initiated by the Clinician in Charge Without Emergency Myocardial Stunning

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Continuous renal replacement therapy arm

Echocardiographic evaluation (with 2D speckle tracking analysis of left ventricular segmental function) 1 hour before and 3 hours after the initiation of continuous renal replacement therapy (continuous veno venous hemofiltration) initiation

Group Type EXPERIMENTAL

Continuous renal replacement therapy

Intervention Type PROCEDURE

Continuous renal replacement therapy (veno venous hemofiltration) without net ultrafiltration, through a dedicated central venous catheter

Control arm

Two echocardiographic evaluations (with 2D speckle tracking analysis of left ventricular segmental function) at an interval of 4 hours, before the continuous renal replacement therapy initiation.

Group Type OTHER

Control group

Intervention Type OTHER

Continuous renal replacement therapy is differed from 6 hours to allowed 2 control echocardiographic evaluations

Interventions

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Continuous renal replacement therapy

Continuous renal replacement therapy (veno venous hemofiltration) without net ultrafiltration, through a dedicated central venous catheter

Intervention Type PROCEDURE

Control group

Continuous renal replacement therapy is differed from 6 hours to allowed 2 control echocardiographic evaluations

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 years old
* Acute Kidney Injury grade 3 (KDIGO)
* Indication for renal replacement therapy for the clinician in charge

Exclusion Criteria

* Emergency indication to renal replacement therapy (pH\<7.15, Kaliemia \> 6mmol/L, refractory pulmonary oedema)
* Poor echogenicity with speckle tracking analysis failure
* Chronic hemodialysis
* Extra corporeal membrane oxygenation, left ventricular assist device.

Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No