The Influence of Furosemide on Fluid Balance and Intra-abdominal Pressure in Critically Ill Patients
Intra-Abdominal Hypertension
About this trial
This is an interventional treatment trial for Intra-Abdominal Hypertension focused on measuring abdominal compartment syndrome, intra-abdominal pressure, furosemide, fluid balance
Eligibility Criteria
Inclusion Criteria:
- Adult (>18y)
- Sedation (Richmond Agitation and Sedation Score RASS ≤ -3) and mechanical ventilation anticipated to last for at least an additional 72h
- Indication for IAP monitoring according to the recommendations published by the WSACS
- IAP ≥ 12mmHg (intravesical IAP measurement according to WSACS guidelines)
- Absence of surgically treatable abdominal lesions
- Presence of fluid overload
Exclusion Criteria:
- Pregnancy or lactation
- Assisted spontaneous breathing ventilator mode
- Chronic diuretic therapy or on diuretics during inclusion
- Contra-indication to bladder catheterization such as bladder surgery or genitourinary trauma
- Known hypersensitivity to furosemide
- Renal failure Acute Kidney Injury Network (AKIN) class 3
- Patients requiring high dose vasopressors (norepinephrine >0.5µg/kg/min, dobutamine >10µg/kg/min or dopamine>10µg/kg/min, epinephrine>0.5µg/kg/min)
- Intra-abdominal pressure (IAP) >25mmHg at study entry
- DNR orders in effect (other than DNR 1 'no CPR' order)
- Patient not expected to survive for 7 days
- Advanced liver cirrhosis (see pharmaceutical information on furosemide)
- paO2/FiO2 ratio of <100
- oliguria <500mL/24h preceding inclusion
Sites / Locations
- ZNA Stuivenberg Intensive Care UnitRecruiting
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Control group
Furosemide group
Patients will be receiving standard of care ICU treatment of their underlying disease according to internationally accepted guidelines and recommendations.
patients will be receiving standard of care ICU treatment of their underlying condition according to international guidelines and recommendations. In addition, furosemide will be administered in continuous infusion as per protocol in order to achieve a preset target diuresis that is adjusted according to haemodynamic tolerance.