Feasibility of conservative fluid administration and deresuscitation compared with usual care in critical illness: the Role of Active Deresuscitation After Resuscitation-2 (RADAR-2) randomised clinical trial
| العنوان: | Feasibility of conservative fluid administration and deresuscitation compared with usual care in critical illness: the Role of Active Deresuscitation After Resuscitation-2 (RADAR-2) randomised clinical trial |
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| المؤلفون: | Jonathan A. Silversides, Ross McMullan, Lydia M. Emerson, Ian Bradbury, Jonathan Bannard-Smith, Tamas Szakmany, John Trinder, Anthony J. Rostron, Paul Johnston, Andrew J. Ferguson, Andrew J. Boyle, Bronagh Blackwood, John C. Marshall, Daniel F. McAuley |
| المصدر: | Silversides, J A, McMullan, R, Emerson, L M, Bradbury, I, Bannard-Smith, J, Szakmany, T, Trinder, T J, Rostron, A J, Johnston, P, Ferguson, A J, Boyle, A J, Blackwood, B, Marshall, J C & McAuley, D F 2021, ' Feasibility of conservative fluid administration and deresuscitation compared with usual care in critical illness: the Role of Active Deresuscitation After Resuscitation-2 (RADAR-2) randomised clinical trial ', Intensive Care Medicine . https://doi.org/10.1007/s00134-021-06596-8 |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Oedema, Infusions, Fluid therapy, Critical illness, Diuretics, Intravenous, Critical Care and Intensive Care Medicine, Water–electrolyte balance, Deresuscitation, RT, RC |
| الوصف: | PURPOSE: Fluid overload is common in critical illness and is associated with mortality. This study investigated the feasibility of a randomised trial comparing conservative fluid administration and deresuscitation (active removal of accumulated fluid using diuretics or ultrafiltration) with usual care in critical illness.METHODS: Open-label, parallel-group, allocation-concealed randomised clinical feasibility trial. Mechanically ventilated adult patients expected to require critical care beyond the next calendar day were enrolled between 24 and 48 h following admission to the intensive care unit (ICU). Patients were randomised to either a 2-stage fluid strategy comprising conservative fluid administration and, if fluid overload was present, active deresuscitation, or usual care. The primary endpoint was fluid balance in the 24 h up to the start of study day 3. Secondary endpoints included cumulative fluid balance, mortality, and duration of mechanical ventilation.RESULTS: One hundred and eighty patients were randomised. After withdrawal of 1 patient, 89 patients assigned to the intervention were compared with 90 patients assigned to the usual care group. The mean plus standard deviation (SD) 24-h fluid balance up to study day 3 was lower in the intervention group (- 840 ± 1746 mL) than the usual care group (+ 130 ± 1401 mL; P CONCLUSIONS: A strategy of conservative fluid administration and active deresuscitation is feasible, reduces fluid balance compared with usual care, and may cause benefit or harm. In view of wide variations in contemporary clinical practice, large, adequately powered trials investigating the clinical effectiveness of conservative fluid strategies in critically ill patients are warranted. |
| وصف الملف: | application/pdf |
| تدمد: | 1432-1238 0342-4642 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5f8b962da27751b4579f09f44f4ecbbe https://doi.org/10.1007/s00134-021-06596-8 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....5f8b962da27751b4579f09f44f4ecbbe |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14321238 03424642 |
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