SCUFFD
Research type
Research Study
Full title
Feasibility of slow continuous ultrafiltration for deresuscitation in critically ill patients
IRAS ID
298679
Contact name
Jon Silversides
Contact email
Sponsor organisation
Belfast Health and Social Care Trust
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Patients who have a life-threatening illness, such as sepsis or pneumonia, often need treatment in an intensive care unit where body function is closely monitored and supported with medications or machines. One important part of treatment in intensive care is fluid balance: making sure that enough fluid is being given to support the heart and blood pressure while trying to avoid fluid overload, which may cause harm due to swelling of tissues and organs. Fluid overload is linked to worse outcomes. Often this is treated with medications, diuretics. If the kidneys are not working, a process called ultrafiltration, using a kidney dialysis machine, is used to remove the fluid instead. Both diuretics and ultrafiltration have advantages and disadvantages. Diuretics remove electrolytes (salts) such as sodium and potassium in varying proportions to water, and there is unpredictability in response and side effects eg high sodium levels. Ultrafiltration allows much better control over the rate of fluid removal, and ensures a balanced removal of water and electrolytes.
In patients who have signs of fluid overload and would normally be given diuretics, we plan to use ultrafiltration instead. Normally this necessitates the use of very large intravenous lines in a central vein (typically in the neck), which carries risk. We aim to investigate whether ultrafiltration to remove excess fluid is possible using the much smaller intravenous lines which ICU patients typically have in place already. If they do not have a suitable line, we would insert small intravenous lines into veins in the arm or leg, like those used routinely in hospital to administer intravenous drugs.
In summary, we aim to see whether ultrafiltration can be feasibly used to treat fluid overload instead of diuretics. We will minimise extra risk by using existing lines where possible and only placing small peripheral lines if needed.
REC name
HSC REC A
REC reference
22/NI/0008
Date of REC Opinion
24 Feb 2022
REC opinion
Further Information Favourable Opinion