PEEP-induced Changed in RRI as Physiological Background of Ventilator-induced Kidney Injury

Università degli Studi di Ferrara105 enrolled

Overview

The renal Doppler resistive index (RRI) is a noninvasive tool that has been used to assess renal perfusion in the intensive care unit (ICU) setting. Many parameters have been described as influential on the values of renal RI. Mechanical ventilation is associated with significant increases in the risk of acute kidney injury (AKI). Ventilator-induced kidney injury (VIKI) is believed to occur due to changes in hemodynamics that impair renal perfusion. The investigators hypothesized that patients who need mechanical ventilation should have a different response in RRI when different levels of Positive end expiratory pressure (PEEP) are applied. Investigators wish to describe changing in RRI due to changes in PEEP and to verify whether these changes could partially explain the occurrence of VIKI

Study Type

OBSERVATIONAL

Enrollment

105

Conditions

Respiratory Distress Syndrome, Adult Respiration, Artificial Acute Kidney Injury

Interventions

All patients will be ventilated with a tidal volume of 6 ml/kg before the RRI assessment. Further, three level of PEEP (5, 10 and 15 cmH2O) will be randomly set. For each levels of PEEP, the RRI will be evaluated

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients admitted to ICU with expected mechanical ventilation \>48h Exclusion Criteria: * Ultrasound RRI evaluation non available * Patients with arrhythmia * Pregnancy

Locations (2)

Università di Ferrara

Ferrara, Italy

Università di Siena

Siena, Italy

Outcomes

Primary Outcomes

Occurence of AKI

AKI will be defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria

Time frame: once a day until day 7

Secondary Outcomes

Change in RRI at different level of PEEP

To compare median difference of RRI at PEEP 5 and PEEP 15 in patients who will develop (or not) AKI

Time frame: One a day until day 5

Data from ClinicalTrials.gov

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