Perfusion Parameters and Outcome During a Standardized Deresuscitation Strategy with Net Ultrafiltration: a Retrospective Cohort Study. (DeepCART)

Hemodynamic tolerance of fluid removal during deresuscitation is a cornerstone of the impact on outcome of such a strategy. However, how to define and to predict hemodynamic tolerance to fluid removal remains controversial. The investigators routinely use a standardized deresuscitation protocol in patients with fluid overload and continuous renal replacement therapy combined with monitoring of clinical and biological perfusion parameters.

The aim of the study was to describe perfusion during deresuscitation, and to determine whether it is associated with major adverse kidney events at day 30.

Study Overview

• Status: Completed
• Conditions: Acute Kidney Injury; Fluid Overload; Continuous Renal Replacement Therapy
• Intervention / Treatment: Other: Describe the perfusion parameters during a deresuscitation strategy and their association with the outcome.

• Study Type: Observational
• Enrollment (Actual): 120

Contacts and Locations

Study Locations

• France
  • Bron
    • France, Bron, France, 69500
      • Louis Pradel Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

adults' patients with fluid overload and continuous renal replacement therapy in intensive care unit

Description

Inclusion Criteria:

• Age ≥ 18 years old
• Acute kidney injury requiring continuous renal replacement therapy
• Standardized deresuscitation following a routine care protocol

Exclusion Criteria:

• Chronic hemodialysis
• Advanced directives to withhold or withdraw life-sustaining treatment,
• Patient's opposition to the use of his/her personal health data

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Standardized deresuscitation strategy; Eligible patients without hypoperfusion benefited from: 1) a restrictive approach of intakes combining hypercaloric enteral or per os feeding with hydric restriction as much as possible and no fluid of maintenance, and 2) a systematic UFnet of 2 mL/kg/h until reaching dry weight and a systematic monitoring every 6 h of: peripheral perfusion by capillary refilling time and mottling score, arterial lactate level, and central venous oxygen saturation.

Other: Describe the perfusion parameters during a deresuscitation strategy and their association with the outcome.; Arterial lactate, pCO2 gap, SvO2, capillary refill time and mottling score anomalies will be described during the first 5 days of the deresuscitation strategy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
MAKE 30	Major adverse kidney event at day 30, defined as follows: Death OR; No weaning of renal replacement therapy OR; Serum creatinine > 2 times baseline serum creatinine	A day 30 after the initiation of the deresuscitation strategy

Collaborators and Investigators

• Sponsor: Hospices Civils de Lyon

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2024
• Primary Completion (Actual): March 1, 2024
• Study Completion (Actual): April 1, 2024

Study Registration Dates

• First Submitted: March 21, 2025
• First Submitted That Met QC Criteria: March 21, 2025
• First Posted (Actual): March 28, 2025

Study Record Updates

• Last Update Posted (Actual): March 28, 2025
• Last Update Submitted That Met QC Criteria: March 21, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Male Urogenital Diseases; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Renal Insufficiency; Acute Kidney Injury
• Other Study ID Numbers: 24-5563

Drug and device information, study documents

• product manufactured in and exported from the U.S.: No