Overview

Stop Hypernatremia, Use Metolazone, for Aggressive, Controlled, Effective Diuresis

Status:
Withdrawn

Trial end date:
2013-06-01

Target enrollment:
0

Participant gender:
All

Summary

Patients who are on mechanical ventilation in an intensive care unit often require diursis as part of their pre-extubation regimen. The drug of choice for diuresis has traditionally been furosemide. However, this drug cause hypernatremia (a rise in serum sodium) in a significant proportion of patients. Hypernatremia is traditionally treated by providing free water supplementation to the patient. This strategy creates a vicious and unproductive cycle of giving free water, and then diuresing it off. We propose a strategy for breaking this cycle by using a second diuretic-- metolazone-- which has a tendency to rid the body of more sodium, thereby minimizing hypernatremia.

Phase:

N/A

Accepts Healthy Volunteers?

Details

Lead Sponsor:

Oregon Health and Science University

Treatments:

Furosemide
Metolazone

Criteria

Inclusion Criteria:

- ICU patients who are intubated and slated for diuresis in anticipation of extubation.

- Patients must be hypernatremic (Na > 140 mEq/L) at the time diuresis is initiated or
become hypernatremic over the course of receiving loop diuretics in anticipation of
extubation.

- GFR > 30 ml/min [as calculated by the MedCalc MDRD formula {GFR = 170 x PCr - 0.999 x
Age - 0.176 x BUN - 0.170 x Albumin0.318 x 0.762 (for women) x 1.180 (for blacks)} ]

Exclusion Criteria:

- History of allergy to furosemide or any thiazide diuretic

- Inability to place enteral access

- Moribund status