Bladder Pressure Predicting Renal Failure in Critically Ill Patients as Compared to Hemodynamic Parameters

Study Overview
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Brief Summary
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Studies have shown that more than 30% of the overall acute decompensated heart failure (ADHF) patients develop renal dysfunction. Several studies have tried to find a correlation between hemodynamic Parameters (blood pressure , heart rate, central venous pressure CVP) and worsening of renal function in acute decompensated heart failure patients. Results showed that there were no correlation between baseline hemodynamics or change in hemodynamics and worsening of renal function. Another study showed that intra-abdominal pressure (IAP) measuring was a better corollary to renal failure status then measuring cardiovascular hemodynamics using pulmonary artery catheterization in ADHF patients.. An increased IAP was associated with worse renal function and that level of IAP far below abdominal compartment syndrome may adversely affect renal function in patients with ADHF.

Official Title
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Is Intravesicular Pressure a Better Tool to Predict Renal Failure in Critically Ill Patients Compared With Routine Hemodynamic Parameters?

Conditions
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Acute Heart Failure, Acute Renal Failure

Intervention / Treatment
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* Device: BARD® Intra-abdominal Pressure monitor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any ICU(intensive care unit) or CCU(critical care unit) patient older than 18 y. Patient diagnosed on admission with pulmonary edema/CHF (fluid in the lungs) - independently from the baseline renal function. No subject will be accepted to take part in the study unless they are able to sign or if Health care proxy signs a consent Exclusion Criteria: Pregnant women Cognitively impaired patients Age<18 yrs old Patients diagnosed on admission with ARDS. Patients admitted with a diagnosis of sepsis ( WBC> 12000, CXR findings consistent with pneumonia, positive blood cultures on admission, UTI)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Acute CHF patients<br>Acute CHF patients with BARD Intra-abdominal pressure monitors in ICU | Device: BARD® Intra-abdominal Pressure monitor<br>* monitor linked to foley catheter that is able to measure pressure inside bladder<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| High intraabdominal pressure and effect on renal function | IAP measurements will be recorded concomitantly with renal indices. Correlations will be made in regard to pressure measurements and worsening renal function. | from admission (baseline) until 72 hours later | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of diuretics use on intrabdominal pressure | Early initiation of diuretics in acute heart failure improvement correlating with decreasing IAP measurements. | 3 days from admission |