Article (Scientific journals)
High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial
JOANNES-BOYAU, Olivier; HONORE, Patrick; PEREZ, Paul et al.
2013In Intensive Care Medicine, 39 (9), p. 1535-1546
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Keywords :
Acute kidney injury; Renal replacement therapy; High volume hemofiltration; Blood purification; Septic shock
Abstract :
[en] PURPOSE : Septic shock is a leading cause of death among critically ill patients, in particular when complicated by acute kidney injury (AKI). Small experimental and human clinical studies have suggested that high-volume haemofiltration (HVHF) may improve haemodynamic profile and mortality. We sought to determine the impact of HVHF on 28-day mortality in critically ill patients with septic shock and AKI. METHODS: This was a prospective, randomized, open, multicentre clinical trial conducted at 18 intensive care units in France, Belgium and the Netherlands. A total of 140 critically ill patients with septic shock and AKI for less than 24 h were enrolled from October 2005 through March 2010. Patients were randomized to either HVHF at 70 mL/kg/h or standard-volume haemofiltration (SVHF) at 35 mL/kg/h, for a 96-h period. RESULTS: Primary endpoint was 28-day mortality. The trial was stopped prematurely after enrolment of 140 patients because of slow patient accrual and resources no longer being available. A total of 137 patients were analysed (two withdrew consent, one was excluded); 66 patients in the HVHF group and 71 in the SVHF group. Mortality at 28 days was lower than expected but not different between groups (HVHF 37.9 % vs. SVHF 40.8 %, log-rank test p = 0.94). There were no statistically significant differences in any of the secondary endpoints between treatment groups. CONCLUSIONS: In the IVOIRE trial, there was no evidence that HVHF at 70 mL/kg/h, when compared with contemporary SVHF at 35 mL/kg/h, leads to a reduction of 28-day mortality or contributes to early improvements in haemodynamic profile or organ function. HVHF, as applied in this trial, cannot be recommended for treatment of septic shock complicated by AKI.
Disciplines :
Anesthesia & intensive care
Author, co-author :
JOANNES-BOYAU, Olivier;  CENTRE HOSPITALIER UNIVERSITAIRE de Bordeaux, France > Service d'Anesthésie-Réanimation 2
HONORE, Patrick;  UNIVERSITAIR ZIEKENHUIS BRUSSEL > Vrije Universiteit Brussel (VUB) > Médecine Intensive
PEREZ, Paul;  CHU BORDEAUX > Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique
BAGSHAW, Sean;  UNIVERSITY OF ALBERTA - Edmonton (Canada) > Faculty of Medicine and Dentistery > Division of Critical Care Medicine
GRAND, Hubert;  HOPITAL R. BOULIN - Libourne (France) > POLE EPURS > Réanimation Polyvalente
CANIVET, Jean-Luc ;  Centre Hospitalier Universitaire de Liège - CHU > Soins Intensifs Généraux
DEWITTE, Antoine;  CENTRE HOSPITALIER UNIVERSITAIRE de Bordeaux, France > Service d'Anesthésie-Réanimation 2
FLAMENS, Claire;  HOPITAL CARDIOVASCULAIRE ET PNEUMOLOGIE LOUIS PRADEL de Lyon, France > Service d'Anesthésie-Réanimation
PUJOL, Wilfried;  CLINIQUE BORDEAUX NORD AQUITAINE de Bordeaux, France > Service de Réanimation
GRANDOULIER, Anne-Sophie;  CHU de Bordeaux, France > Pôle de Santé Publique et CIC-EC7 > Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (USMR)
FLEUREAU, Catherine;  CENTRE HOSPITALIER de Bordeaux, France > Service d'Anesthésie-Réanimation 2
JACOBS, Rita;  UNIVERSITAIR ZIEKENHUIS BRUSSEL (VUB) > Médecine Intensive
BROUX, Christophe;  HOPITAL ALBERT MICHALLON de Grenoble, France > Anesthésie et Soins Intensifs
FLOCH, Hervé;  HOPITAL DE LA CAVALE BLANCHE - CHU de Brest, France > Réanimation Chirurgicale
BRANCHARD, Olivier;  CHU de Bordeaux, France > Service d'Anesthésie-Réanimation 2
FRANCK, Stéphane;  HOPITAL TIVOLI - ULB, La Louvière > Service de Soins Intensifs
ROZE, Hadrien;  CHU de Bordeaux, France > Service d'Anesthésie-Réanimation 2
COLLIN, Vincent;  CLINIQUE DE L'EUROPE - Site Saint-Michel > Service de Soins Intensifs
BOER, Willem;  ZIEKENHUIS OOST-LIMBURG de Genk > Anesthesiology and Critical Care Medicine
CALDERON, Joachim;  CHU de Bordeaux, France > Service d'Anesthésie-Réanimation 2
GAUCHE, Bernard;  HOPITAL R. BOULIN de Libourne, France > Pôle EPURS > Réanimation Polyvalente
SPAPEN, Herbert;  UNIVERSITAIR ZIEKENHUIS BRUSSEL - VUB > Médecine Intensive
JANVIER, Gérard;  CHU de Bordeaux, France > Service d'Anesthésie-Réanimation 2
OUATTARA, Alexandre;  CHU de Bordeaux, France > Service d'Anesthésie-Réanimation 2
More authors (14 more) Less
Language :
English
Title :
High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial
Publication date :
September 2013
Journal title :
Intensive Care Medicine
ISSN :
0342-4642
eISSN :
1432-1238
Publisher :
Springer Verlag, New York, United States - New York
Volume :
39
Issue :
9
Pages :
1535-1546
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 18 January 2016

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