dc.contributor.author | Vaara, ST | |
dc.contributor.author | Ostermann, M | |
dc.contributor.author | Bitker, L | |
dc.contributor.author | Schneider, A | |
dc.contributor.author | Poli, E | |
dc.contributor.author | Hoste, E | |
dc.contributor.author | Fierens, J | |
dc.contributor.author | Joannidis, M | |
dc.contributor.author | Zarbock, A | |
dc.contributor.author | van Haren, F | |
dc.contributor.author | Prowle, J | |
dc.contributor.author | Selander, T | |
dc.contributor.author | Bäcklund, M | |
dc.contributor.author | Pettilä, V | |
dc.contributor.author | Bellomo, R | |
dc.contributor.author | REVERSE-AKI study team | |
dc.date.accessioned | 2021-05-21T11:08:16Z | |
dc.date.available | 2021-04-01 | |
dc.date.available | 2021-05-21T11:08:16Z | |
dc.date.issued | 2021-05-07 | |
dc.identifier.citation | Vaara, S.T., Ostermann, M., Bitker, L. et al. Restrictive fluid management versus usual care in acute kidney injury (REVERSE-AKI): a pilot randomized controlled feasibility trial. Intensive Care Med (2021). https://doi.org/10.1007/s00134-021-06401-6 | en_US |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/71975 | |
dc.description.abstract | PURPOSE: We compared a restrictive fluid management strategy to usual care among critically ill patients with acute kidney injury (AKI) who had received initial fluid resuscitation. METHODS: This multicenter feasibility trial randomized 100 AKI patients 1:1 in seven ICUs in Europe and Australia. Restrictive fluid management included targeting negative or neutral daily fluid balance by minimizing fluid input and/or enhancing urine output with diuretics administered at the discretion of the clinician. Fluid boluses were administered as clinically indicated. The primary endpoint was cumulative fluid balance 72 h from randomization. RESULTS: Mean (SD) cumulative fluid balance at 72 h from randomization was - 1080 mL (2003 mL) in the restrictive fluid management arm and 61 mL (3131 mL) in the usual care arm, mean difference (95% CI) - 1148 mL (- 2200 to - 96) mL, P = 0.033. Median [IQR] duration of AKI was 2 [1-3] and 3 [2-7] days, respectively (median difference - 1.0 [- 3.0 to 0.0], P = 0.071). Altogether, 6 out of 46 (13%) patients in the restrictive fluid management arm and 15 out of 50 (30%) in the usual care arm received renal replacement therapy (RR 0.42; 95% CI 0.16-0.91), P = 0.043. Cumulative fluid balance at 24 h and 7 days was lower in the restrictive fluid management arm. The dose of diuretics was not different between the groups. Adverse events occurred more frequently in the usual care arm. CONCLUSIONS: In critically ill patients with AKI, a restrictive fluid management regimen resulted in lower cumulative fluid balance and less adverse events compared to usual care. Larger trials of this intervention are justified. | en_US |
dc.language | eng | |
dc.language.iso | en | en_US |
dc.relation.ispartof | Intensive Care Medicine | |
dc.rights | Creative Commons Attribution-NonCommercial 4.0 International License | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | |
dc.subject | Acute kidney injury | en_US |
dc.subject | Critically ill | en_US |
dc.subject | Fluid balance | en_US |
dc.subject | Restrictive fluid management | en_US |
dc.title | Restrictive fluid management versus usual care in acute kidney injury (REVERSE-AKI): a pilot randomized controlled feasibility trial. | en_US |
dc.type | Article | en_US |
dc.rights.holder | © 2021 The Author(s) | |
dc.identifier.doi | 10.1007/s00134-021-06401-6 | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/33961058 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published online | en_US |
dcterms.dateAccepted | 2021-04-01 | |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |