The Influence of Furosemide on Fluid Balance and Intra-abdominal Pressure in Critically Ill Patients

• Status: Unknown status
• Trial end date: 2012-03-01
• Target enrollment: 0
• Participant gender: All

Summary

Intra-abdominal hypertension (IAH) is a frequent cause of organ dysfunction in critically ill patients. Secondary IAH is mainly caused by excessive fluid resuscitation.The World Society for the Abdominal Compartment Syndrome (WSACS) recommends using diuretics to remove excess fluids and decrease intra-abdominal pressure (IAP). However, critically ill patients may not tolerate negative fluid balance in the acute phase of their disease and the injured kidney may not respond to diuretics. The aim of this study is to evaluate the influence of furosemide on fluid balance, IAP and kidney function in critically ill patients.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Ziekenhuis Netwerk Antwerpen (ZNA)
• Treatments: Furosemide

Criteria

Inclusion Criteria:

• Adult (>18y)

• Sedation (Richmond Agitation and Sedation Score RASS ≤ -3) and mechanical ventilation anticipated to last for at least an additional 72h

• Indication for IAP monitoring according to the recommendations published by the WSACS

• IAP ≥ 12mmHg (intravesical IAP measurement according to WSACS guidelines)

• Absence of surgically treatable abdominal lesions

• Presence of fluid overload

Exclusion Criteria:

• Pregnancy or lactation

• Assisted spontaneous breathing ventilator mode

• Chronic diuretic therapy or on diuretics during inclusion

• Contra-indication to bladder catheterization such as bladder surgery or genitourinary trauma

• Known hypersensitivity to furosemide

• Renal failure Acute Kidney Injury Network (AKIN) class 3

• Patients requiring high dose vasopressors (norepinephrine >0.5µg/kg/min, dobutamine >10µg/kg/min or dopamine>10µg/kg/min, epinephrine>0.5µg/kg/min)

• Intra-abdominal pressure (IAP) >25mmHg at study entry

• DNR orders in effect (other than DNR 1 'no CPR' order)

• Patient not expected to survive for 7 days

• Advanced liver cirrhosis (see pharmaceutical information on furosemide)

• paO2/FiO2 ratio of <100

• oliguria <500mL/24h preceding inclusion