AKI Prevention and Early Intervention in VAD Patients Admitted for Acute Medical Events.
研究概览
详细说明
The purpose of the study is to investigate whether preventive measures for newly hospitalized ventricular assist device (VAD) patients will reduce the Acute Kidney Injury (AKI) occurrence rate, progression and associated complications
Participants will be in the study for the first 7 days of hospitalization. The study investigators will access the electronic medical record daily from admission day 1 through admission day 7 in order to provide clinical recommendations in an effort to minimize AKI risk as per routine practice.
If the patient is discharged prior to day 7 the study, intervention will be terminated on day of discharge.
The investigators will review the participant's medical record up to one year after surgery.
This study will not include any experimental laboratory tests or experimental medication.
The clinical recommendations will regard the following:
- Avoidance of potentially nephrotoxic medications (e.g. NSAIDs, intravascular contrast, nephrotoxic antimicrobials)
- Optimizing volume status (avoidance of volume overload or depletion)
- Optimizing electrolytes and acid-base status
- Optimizing hemodynamics (Mean arterial BP>65mmHg)
- Assessment of kidney function with serum creatinine and/or cystatin C None of the suggestions will be experimental. All suggestions will be based on standard nephrology practice.
The investigators plan to compare the results of the current study with those in in the years of 2012-2017 (1/7/2012- 1/7/2017) via retrospective chart review
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
-
-
Arizona
-
Scottsdale、Arizona、美国、85259
- Mayo Clinic in Arizona
-
-
Florida
-
Jacksonville、Florida、美国、32224
- Mayo Clinic in Florida
-
-
Minnesota
-
Rochester、Minnesota、美国、55905
- Mayo Clinic in Rochester
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion criteria:
Adult patients with VAD in place who are admitted to the hospital for acute medical illness during the study period. For those with multiple admissions during the study period only the first admission will be studied.
Patients who are able to give consent. In case of patients that are mentally impaired we will obtain consent from power of attorney and when patients regain intact mental capacity we will reobtain consent from the patient.
Exclusion criteria:
Patients on dialysis (hemodialysis or peritoneal dialysis).
学习计划
研究是如何设计的？
设计细节
- 主要用途：预防
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
其他：Subjects with VAD in place
Adult patients with VAD in place who are admitted to the hospital for acute medical illness.
The investigators will provide clinical recommendations to the subject's primary care provider.
|
The clinical recommendations will regard the following:
None of the suggestions will be experimental. All suggestions will be based on standard nephrology practice. |
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Rate of AKI in hospitalized VAD patients based on AKIN criteria
大体时间：The first 7 days of hospitalization
|
The AKIN staging system has 3 stages: 1) serum creatinine increase ≥ 26.5 umol/L or increase to 1.5-2.0
fold from baseline, OR urine output <0.5 ml/kg/h for 6 h; 2) serum creatinine increase > 2.0-3.0 fold from baseline OR urine output <0.5 ml/kg/h for 12 h; 3) serum creatinine increase >3.0 fold from baseline OR serum creatinine ≥354 umol/l with an acute increase of at least 44 umol/l or need for Renal Replacement Therapy (RRT) OR urine output <0.3 ml/kg/h for 24 h OR anuria for 12 OR need for RRT
|
The first 7 days of hospitalization
|
|
Severity of AKI based on AKIN stages (I, II, III) 1
大体时间：The first 7 days of the hospitalization
|
The AKIN staging system has 3 stages: 1) serum creatinine increase ≥ 26.5 umol/L or increase to 1.5-2.0
fold from baseline, OR urine output <0.5 ml/kg/h for 6 h; 2) serum creatinine increase > 2.0-3.0 fold from baseline OR urine output <0.5 ml/kg/h for 12 h; 3) serum creatinine increase >3.0 fold from baseline OR serum creatinine ≥354 umol/l with an acute increase of at least 44 umol/l or need for Renal Replacement Therapy (RRT) OR urine output <0.3 ml/kg/h for 24 h OR anuria for 12 OR need for RRT
|
The first 7 days of the hospitalization
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Length of hospital stay
大体时间：One year after hospitalization
|
The length of hospital stay will be determined from the electronic medical record.
|
One year after hospitalization
|
|
In hospital, 60 day and one-year mortality
大体时间：One year after enrollment
|
The number of subjects who died during hospitalization, 60 days after hospitalization and one year after hospitalization
|
One year after enrollment
|
合作者和调查者
赞助
调查人员
- 首席研究员：Qi Qian、Mayo Clinic
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
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