Status:

RECRUITING

Preventive Versus Curative Treatment of Fluid Overload

Lead Sponsor:

Assistance Publique - Hôpitaux de Paris

Conditions:

Respiratory Insufficiency

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

Fluid overload is associated with a poor prognosis in critically ill patients, especially during weaning from mechanical ventilation as it may promote weaning induced pulmonary edema. Previous data su...

Detailed Description

Mechanical ventilation is a cornerstone treatment for critically ill patients that is however associated with complications that may alter the prognosis. A major objective is therefore to separate pat...

Eligibility Criteria

Inclusion

  • age\>18
  • intubation and mechanical ventilation \>= 24 hours
  • cumulative fluid balance judged positive or increase in body weight since admission
  • clinical stability as defined by: 4.1. stable oxygenation (SpO2 ≥ 90 % with FiO2 ≤ 50 % and positive end-expiratory pressure (PEEP) ≤ 8 cm H2O) 4.2. stable hemodynamics (no pressors, no fluid expansion within the last 12 hours) 4.3. stopped or decreased sedation within the last 48 hours and stable neurologic state.
  • 4. temperature \>36,0 ◦C and \< 39◦C
  • consent signed by the patient or next of kin or emergency procedure

Exclusion

  • extracorporal membrane oxygenation
  • pregnancy or breastfeeding
  • allergy to furosemide, sulfamides or spironolactone
  • tracheotomy
  • hydrocephaly
  • acute right ventricle failure
  • cardiac arrest with estimated poor prognosis
  • already enrolled in an interventional study on weaning from mechanical ventilation
  • Guillain Barre, myasthenia crisis
  • planned extubation on the day
  • criteria of clinical stability (as described above) present since more than 24 hours
  • natremia \> 150 mEq/L, kaliemia \< 3.5 mEq/L, metabolic alkalosis with pH\>7.5
  • administration of iodinated contrast within the last 6 hours
  • ongoing or planned use of artificial kidney within the next 48 hours
  • no affiliation to the health insurance system
  • patient under curatorship
  • imprisoned patient

Key Trial Info

Start Date :

February 1 2020

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

March 1 2024

Estimated Enrollment :

410 Patients enrolled

Trial Details

Trial ID

NCT04050007

Start Date

February 1 2020

End Date

March 1 2024

Last Update

January 17 2024

Active Locations (1)

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1

GH Pitié Salpêtrière - Charles Foix

Paris, France, 75013