Evidence map›Paper›PMID 29562937›Full record

ArticleTrials2018

Cerebral microembolism in the critically ill with acute kidney injury (COMET-AKI trial): study protocol for a randomized controlled clinical trial.

Gabor Erdoes, Dominik E Uehlinger, Beatrice Kobel, Monika P Stucki, Roland Wiest, Frank Stueber, Niklaus Fankhauser, Stephan M Jakob, Joerg C Schefold

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02621749 (Cerebral Microembolism in the Critically Ill With Acute Kidney Injury), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02621749 naterminatednot on this map

Cerebral Microembolism in the Critically Ill With Acute Kidney Injury: A Prospective Multi-Center Randomized Controlled Trial Comparing Continuous With Intermittent Renal Replacement Therapy.

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2017 to 2022Enrolled66ConditionsCerebral EmbolismArmsRenal replacement therapy
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Gabor ErdoesDepartment of Anesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland. gabor.erdoes@insel.ch.ORCID http://orcid.org/0000-0002-6742-1016
Dominik E UehlingerDepartment of Nephrology and Hypertension, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
Beatrice KobelDepartment of Anesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.
Monika P StuckiDepartment of Anesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.
Roland WiestInstitute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
Frank StueberDepartment of Anesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.
Niklaus FankhauserClinical Trials Unit (CTU), University of Bern, 3012, Bern, Switzerland.
Stephan M JakobDepartment of Intensive Care Medicine, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
Joerg C SchefoldDepartment of Intensive Care Medicine, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
University of Bern · CH

Funding

European Society of Intensive Care Medicine Next Start-up Grant
6 · The paper itself

Abstract

backgroundMicroembolism is a frequent pathological event during extracorporeal renal replacement therapy (RRT). Some previous data indicate that microemboli are generated in patients who are undergoing RRT and that these may contribute to increased cerebrovascular and neurocognitive morbidity in patients with end-stage renal disease. The current trial aims to quantify the microembolic load and respective qualitative composition that effectively reaches the intracerebral circulation in critically ill patients treated with different RRT modalities for acute kidney injury (AKI). METHODS/

designThe COMET-AKI trial is a prospective, randomized controlled clinical trial with a 2-day clinical assessment period and follow-up visits at 6 and 12 months. Consecutive critically ill patients with AKI on continuous renal replacement therapy (CRRT) scheduled for a switch to intermittent renal replacement therapy (IRRT) will be randomized to either switch to IRRT within the next 24 h or continued CRRT for an additional 24 h. Cerebral microembolic load will be determined at baseline, i.e., before switch (on CRRT for both groups) and on IRRT versus CRRT, whichever group they were randomized to. The primary endpoint is defined as the difference in mean total cerebral microemboli count during the measurement period on CRRT versus IRRT following randomization. Microemboli will be assessed within the RRT circuit by a 1.5-MHz ultrasound detector attached to the venous RRT tubing and cerebral microemboli will be measured in the middle cerebral artery using a 1.6-MHz robotic transcranial Doppler system with automatic classification of Doppler signals as solid or gaseous. In addition to Doppler measurements, patients will be examined by magnetic resonance imaging and neurocognitive tests to gain better understanding into the potential morphological and clinical consequences of embolization. DISCUSSION: The results of COMET-AKI may help to gain a better insight into RRT modality-associated differences regarding microbubble generation and the cerebral microembolic burden endured by RRT recipients. Furthermore, identification of covariates of microbubble formation and distribution may help to encourage the evolution of next-generation RRT circuits including machinery and/or filters.

trial registrationClinicalTrials.gov, ID: NCT02621749 . Registered on 3 December 2015.

Indexed as

Critical IllnessRandomized Controlled Trials as TopicAcute Kidney InjuryCognitionData Interpretation, StatisticalHumansIntracranial EmbolismMagnetic Resonance ImagingProspective StudiesRenal Replacement TherapyUltrasonography, Doppler, TranscranialAcute kidney injuryCerebral microembolismCritically ill patientsRenal replacement therapy

Identifiers

PMID29562937
PMCPMC5861658
OpenAlexW2807328634

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.