- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT06109714
Tidlig biomarkør nyreskadevurdering efter skarpsindighed rettet væskebehandling i hjertekirurgi (BE-KIND)
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.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
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.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
- Navn: Reney A Henderson, MD
- Telefonnummer: 4103283961
- E-mail: rhenderson@som.umaryland.edu
Undersøgelse Kontakt Backup
- Navn: LaToya Stubbs
- Telefonnummer: 4103289951
- E-mail: lstubbs@som.umaryland.edu
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
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
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Diagnostisk
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: ACUMEN guided resuscitation protocol
Fluid resuscitation and hemodynamic management will be guided by ACUMEN based off a protocol. |
Fluid administration and hemodynamic management guided with the assistance of Edwards Lifesciences ACUMEN monitor |
|
Ingen indgriben: Standard of care resuscitation
Fluid resuscitation will be guided by standard monitors (urine output, blood loss, transesophageal echocardiography). |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Acute Kidney Injury
Tidsramme: 7 days or discharge whichever occurs first
|
KIDIGO Criteria for AKI |
7 days or discharge whichever occurs first
|
|
Renal Biomarkers
Tidsramme: 48 hours postoperatively
|
NGAL, Hepcidin-25, and Uromodulin |
48 hours postoperatively
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Total Fluid Administered
Tidsramme: From initiation of surgery to 48 hours postoperatively
|
intraoperative and postoperative volume given measured in milliliters |
From initiation of surgery to 48 hours postoperatively
|
|
ICU Length of Stay
Tidsramme: From admission to the intensive care unit until discharge or 20 weeks whichever comes first.
|
Quantified in days and hours |
From admission to the intensive care unit until discharge or 20 weeks whichever comes first.
|
|
Hemodynamic Support Usage
Tidsramme: During the first 48 hours postoperatively
|
Vasopressor or Inotrope usage |
During the first 48 hours postoperatively
|
|
Morbidity and Mortality
Tidsramme: 30 days
|
Death and Major adverse events (cerebral vascular stroke, myocardial infarction, infection, prolonged intubation > 24 hours) |
30 days
|
|
Blood Transfusions
Tidsramme: From surgical incision to 48 hours postoperatively
|
Any Allogeneic Blood Transfusions |
From surgical incision to 48 hours postoperatively
|
Samarbejdspartnere og efterforskere
Efterforskere
- Ledende efterforsker: Reney A Henderson, MD, University of Maryland, Baltimore
Publikationer og nyttige links
Generelle publikationer
- 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.
- 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.
- 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.
- 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.
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- HP-00100950
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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