Early Biomarker Kidney Injury Assessment After Acumen Directed Fluid Management in Cardiac Surgery

NCT ID: NCT06109714

Last Updated: 2025-05-16

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-01

Study Completion Date

2028-12-31

Brief Summary

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This study is to assess the benefits of goal-directed fluid management with ACUMEN in cardiac surgical patients and its impact on cardiac surgery-induced kidney injury.

Detailed Description

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This study is to assess the benefits of goal-directed fluid management with ACUMEN in cardiac surgical patients undergoing a CABG, AVR, or CABG/AVR. Kidney injury biomarkers NGAL, Uromodulin, and Hepcidin-25 will be used to assess cardiac-induced kidney injury. Patients will be randomly enrolled in either standard care for fluid management or goal-directed fluid management with ACUMEN.

Conditions

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Renal Injury Acute Kidney Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Participants

Study Groups

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ACUMEN guided resuscitation protocol

Fluid resuscitation and hemodynamic management will be guided by ACUMEN based off a protocol.

Group Type EXPERIMENTAL

Goal Directed Fluid Therapy

Intervention Type OTHER

Fluid administration and hemodynamic management guided with the assistance of Edwards Lifesciences ACUMEN monitor

Standard of care resuscitation

Fluid resuscitation will be guided by standard monitors (urine output, blood loss, transesophageal echocardiography).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Goal Directed Fluid Therapy

Fluid administration and hemodynamic management guided with the assistance of Edwards Lifesciences ACUMEN monitor

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult patients undergoing cardiopulmonary bypass
* Procedure coronary artery bypass grafting, aortic valve replacement, or both

Exclusion Criteria

* Patients \< 18 years old
* Emergent surgery
* Preoperative kidney disease (Cr \> 2.0 or on renal replacement therapy)
* Ejection fraction \< 40%
* Incomplete data in medical record
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Maryland, Baltimore

OTHER

Sponsor Role lead

Responsible Party

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Reney Henderson

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Reney A Henderson, MD

Role: PRINCIPAL_INVESTIGATOR

University of Maryland, Baltimore

Central Contacts

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Reney A Henderson, MD

Role: CONTACT

4103283961

LaToya Stubbs

Role: CONTACT

4103289951

References

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Kullmar M, Massoth C, Ostermann M, Campos S, Grau Novellas N, Thomson G, Haffner M, Arndt C, Wulf H, Irqsusi M, Monaco F, Di Prima A, Garcia Alvarez M, Italiano S, Cegarra SanMartin V, Kunst G, Nair S, L'Acqua C, Hoste EAJ, Vandenberghe W, Honore PM, Kellum J, Forni L, Grieshaber P, Weiss R, Gerss J, Wempe C, Meersch M, Zarbock A. Biomarker-guided implementation of the KDIGO guidelines to reduce the occurrence of acute kidney injury in patients after cardiac surgery (PrevAKI-multicentre): protocol for a multicentre, observational study followed by randomised controlled feasibility trial. BMJ Open. 2020 Apr 6;10(4):e034201. doi: 10.1136/bmjopen-2019-034201.

Reference Type BACKGROUND
PMID: 32265240 (View on PubMed)

Vives M, Hernandez A, Parramon F, Estanyol N, Pardina B, Munoz A, Alvarez P, Hernandez C. Acute kidney injury after cardiac surgery: prevalence, impact and management challenges. Int J Nephrol Renovasc Dis. 2019 Jul 2;12:153-166. doi: 10.2147/IJNRD.S167477. eCollection 2019.

Reference Type BACKGROUND
PMID: 31303781 (View on PubMed)

Van den Eynde J, Schuermans A, Verbakel JY, Gewillig M, Kutty S, Allegaert K, Mekahli D. Biomarkers of acute kidney injury after pediatric cardiac surgery: a meta-analysis of diagnostic test accuracy. Eur J Pediatr. 2022 May;181(5):1909-1921. doi: 10.1007/s00431-022-04380-4. Epub 2022 Jan 17.

Reference Type BACKGROUND
PMID: 35039910 (View on PubMed)

Nadim MK, Forni LG, Bihorac A, Hobson C, Koyner JL, Shaw A, Arnaoutakis GJ, Ding X, Engelman DT, Gasparovic H, Gasparovic V, Herzog CA, Kashani K, Katz N, Liu KD, Mehta RL, Ostermann M, Pannu N, Pickkers P, Price S, Ricci Z, Rich JB, Sajja LR, Weaver FA, Zarbock A, Ronco C, Kellum JA. Cardiac and Vascular Surgery-Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group. J Am Heart Assoc. 2018 Jun 1;7(11):e008834. doi: 10.1161/JAHA.118.008834. No abstract available.

Reference Type BACKGROUND
PMID: 29858368 (View on PubMed)

Other Identifiers

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HP-00100950

Identifier Type: -

Identifier Source: org_study_id

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