Fluid OverloadCritical Care, Intensive CareDeresuscitation
Study summary
Fluid deresuscitation is an important intervention in the Intensive Care Unit (ICU). This study aims to find (1) determinants of successful deresuscitation, (2) the optimal rate (dose) of deresuscitation based on these determinants, and (3) differences in metabolic profiles for a more personalized approach of deresuscitation.
This study is a multicenter, prospective, observational cohort study in critically ill patients. This study will include ICU patients who have a clinical indication for deresuscitation as set by the treating physician. Clinical, ultrasound and laboratory values will be collected and used for analysis.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Admission to one of the participating ICUs;
* Clinical indication for deresuscitation using diuretics or ultrafiltration as set by the treating physician; first attempt during the ICU stay.
Exclusion Criteria:
* Age below 18 years old;
* Major cardiac shunts;
* Moderate to severe aortic regurgitation;
* Morbid Obesisty (BMI \>40);
* POCUS impossible or unreliable (i.e. pre-existing interstitial lung disease);
* PLR or modified form of PLR impossible (i.e. ECMO);
* Transfer from another ICU;
* Previous inclusion in this study;
* Patients who are moribund or facing the end of life;
* Opt out.
Primary outcome measure(s)
Successful deresuscitation without hemodynamic consequences — 24 hours Reach negative fluid balance in first 24 hours without hemodynamic consequences (yes/no), defined as either hypotension or hypoperfusion:
1. Hypotension
* Interventions required to maintain blood pressure MAP \> 65mmHg
* Deresuscitation is stopped
* Fluid bolus needs to be given
* Noradrenaline (or other vasopressor) needs to be initiated, increased to \> 0.2 microg/kg/min, or increased by 50%
* Dose reduction or interruption of RRT
2. Hypoperfusion (one of the following):
* Arterial lactate level \>3 and/or increased 25% or more
* New development of mottled skin
* Capillary refill time \> 3 seconds
* New oliguria (urine output \< 0.3-0.5ml/kg/hour for the previous 6 hours)
Trial sites (2)
Facility
City
Region
Status
OLVG
Amsterdam
Netherlands
Recruiting
Amsterdam UMC
Amsterdam
Netherlands
Recruiting
More Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) trials in the Netherlands
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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