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Restrictive fluid management versus usual care in acute kidney injury (REVERSE-AKI): a pilot randomized controlled feasibility trial by Suvi T. Vaara; Marlies Ostermann; Laurent Bitker; Antoine Schneider; Elettra Poli; Eric Hoste; Jan Fierens; Michael Joannidis; Alexander Zarbock; Frank van Haren; John Prowle; Tuomas Selander; Minna Bäcklund; Ville Pettilä; Rinaldo Bellomo; Rinaldo Bellomo; Suvi Vaara; Laurent Bitker; Glenn Eastwood; Frank van Haren; Liam Byrne; Mary Nourse; Samantha Adam; Clare Robertson; Josie Russell-Brown; Shakira Spiller; Eric Hoste; Jan Fierens; Pieter Nepuydt; Daisy Vermeiren; Ingrid Herck; Druwe Patrick; Luc De Crop; Stephanie Bracke; Marlies Ostermann; Andy Retter; Sara Campos; Gill Arbane; Andrea Kelly; Neus Grau Novellas; Rosario Lim; Martina Marotti; Aneta Bociek; Tim Jones; Christopher Whitton; Andrew Slack; Luigi Camporota; Simon Sparkes; Duncan Wyncoll; Suvi Vaara; Minna Bäcklund; Ville Pettilä; Jonna Heinonen; Leena Pettilä; Sari Sutinen; Elina Lappi; Antoine Schneider; Elettra Poli; Marco Altarelli; Michel Thibault; Philippe Eckert; Madeleine Schnorf; John Prowle; Ryan Haines; Richard Cashmore; Alex Fowler; Filipa Dos Santos; Amaia Garcia; Maria Fernandez; Tim Martin; Ruzena Uddin; on behalf of the REVERSE-AKI study team is a Medicine article available to read on EtoBox.

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## 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 0.1

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Author

Suvi T. Vaara; Marlies Ostermann; Laurent Bitker; Antoine Schneider; Elettra Poli; Eric Hoste; Jan Fierens; Michael Joannidis; Alexander Zarbock; Frank van Haren; John Prowle; Tuomas Selander; Minna Bäcklund; Ville Pettilä; Rinaldo Bellomo; Rinaldo Bellomo; Suvi Vaara; Laurent Bitker; Glenn Eastwood; Frank van Haren; Liam Byrne; Mary Nourse; Samantha Adam; Clare Robertson; Josie Russell-Brown; Shakira Spiller; Eric Hoste; Jan Fierens; Pieter Nepuydt; Daisy Vermeiren; Ingrid Herck; Druwe Patrick; Luc De Crop; Stephanie Bracke; Marlies Ostermann; Andy Retter; Sara Campos; Gill Arbane; Andrea Kelly; Neus Grau Novellas; Rosario Lim; Martina Marotti; Aneta Bociek; Tim Jones; Christopher Whitton; Andrew Slack; Luigi Camporota; Simon Sparkes; Duncan Wyncoll; Suvi Vaara; Minna Bäcklund; Ville Pettilä; Jonna Heinonen; Leena Pettilä; Sari Sutinen; Elina Lappi; Antoine Schneider; Elettra Poli; Marco Altarelli; Michel Thibault; Philippe Eckert; Madeleine Schnorf; John Prowle; Ryan Haines; Richard Cashmore; Alex Fowler; Filipa Dos Santos; Amaia Garcia; Maria Fernandez; Tim Martin; Ruzena Uddin; on behalf of the REVERSE-AKI study team

Publisher

Springer Science and Business Media LLC

Published

2021

Language

EN

Field

Medicine (Health Sciences)