To determine the feasibility and safety of deresuscitation using slow continuous ultrafiltration with regional citrate anticoagulation and peripheral or standard central venous access.
Fluid deresuscitation has been shown to have favourable outcomes in the management of the critically ill patient. Whilst diuretic medications have previously been the mainstay of achieving this deresuscitation, the metabolic and biochemical complications associated with their use can limit their application. Mechanical ultrafiltration is another means of achieving fluid deresuscitation and has theoretical benefits over the use of intravenous diuretics. It allows a more titratable process, without the potential metabolic complications. The use of ultrafiltration has been limited by the requirement of wide bore central venous access. The SCUFFD study is a means of assessing whether ultrafiltration with regional anticoagulation can be achieved through standard central or peripheral venous access.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Ultrafiltration through much smaller intravenous cannula than what has previously been used.
Belfast City Hospital
Belfast, Down, United Kingdom
Number of patients with daily fluid balance within 500 mL of prescribed target
Assessing the feasibility of managing to achieve the target fluid balance
Time frame: 5 days per patient
Number of patients with filter or circuit thrombosis requiring discontinuation of therapy
Ensuring that the process of haemofiltration does not result in unacceptable levels of thrombotic events
Time frame: 5 days per patient
Total volume of fluid removed using ultrafiltration
Assessing the feasibility of fluid removal by ultrafiltration
Time frame: 5 days per patient
Circuit lifespan
The lifespan of each ultrafiltration circuit, to assess the feasibility of using this method as a therapeutic option
Time frame: 5 days per patient
Number of patients developing citrate accumulation
Defined as systemic total:ionised calcium ratio greater than 2.5
Time frame: 5 days
Number of patients developing metabolic alkalosis
Defined as new onset Bicarbonate\>30 and pH \>7.5
Time frame: 5 days
Number of patients developing metabolic acidosis
Defined as new onset Bicarbonate\<18 and pH\<7.30
Time frame: 5 days
Number of patients with a significant change in sodium
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Defined as new onset change in sodium \>8mmol/l in 24 hours or less
Time frame: 5 days per patient
Number of patients developing new onset hyponatraemia
Defined as new onset sodium \<130mmol/l
Time frame: 5 days per patient
Number of patients developing new onset hypernatraemia
Defined as new onset sodium \>150mmol/l
Time frame: 5 days per patient
Number of patients developing new onset hypokalaemia
Defined as new onset potassium \< 3mmol/l
Time frame: 5 days per patient