Standard vs. carbone dioxide adapted kidney replacement therapy in hypercapnic acute respiratory distress syndrome (ARDS) patients: a randomized controlled pilot trial (BigBIC)
Authors' conclusion
Tailoring CKRT to physiological renal compensation of respiratory acidosis appears feasible and safe with the potential to improve patient care in hypercapnic ARDS.
Study context
- Population
- Mechanically ventilated hypercapnic ARDS patients (pCO2 > 7.33 kPa) receiving regional citrate anticoagulation-based continuous kidney replacement therapy (CKRT)5 excluded before treatment
- Participants
- 40 participants
- Comparison
- pCO2-adapted CKRT vs standard CKRT
- pCO2-adapted-CKRTn = 21
- Controln = 19reference
- Primary endpoint
- Plasma bicarbonate
- Follow-up
- 72 h
Methodological detailspilot, multicentre (five ICUs), Study duration six days; endpoints assessed in all patients receiving treatment
- Pilot
- Multicentre (five ICUs)
- Study duration six days; endpoints assessed in all patients receiving treatment
Primary result
As reported in the abstract
P < 0.0001
Secondary outcomes
Thirty-day mortality · 30 days
P = 0.26
Lung protective ventilation (tidal volume < 8 ml/kg predicted body weight)
- More patients in the intervention group received lung protective ventilation
Original publication
Standard vs. carbone dioxide adapted kidney replacement therapy in hypercapnic ARDS patients: a randomized controlled pilot trial (BigBIC). Crit Care. Published 11 June 2024. doi:10.
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