ArticleAnnals of intensive care2020
Bedside prediction of intradialytic hemodynamic instability in critically ill patients: the SOCRATE study.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07643597 (Volume Removal Intolerance During Net Ultrafiltration in Acute Kidney Injury Patients), which is not on this map. Cited by 13 papers, 2 of them syntheses that pooled it.
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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.
Volume Removal Intolerance During Net Ultrafiltration in Acute Kidney Injury Patients
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prediction of intradialytic hypotension by machine learning: A systematic review.Journal of nephrology · 2025Pooled it
- Prognostic value of capillary refill time in adult patients: a systematic review with meta-analysis.Critical care (London, England) · 2023Pooled it
- Article
- The value of pleth variability index in predicting hypotension during maintenance hemodialysis: a prospective observational multicenter study (PVi-HD study).BMC nephrology · 2026Observational
- Ultrafiltration in the critically ill patient: a framework for personalized care.Critical care (London, England) · 2026Review
- Predictive performance of central venous oxygen saturation, lactate, base excess, and alactic base excess for intradialytic hypotension.BMC nephrology · 2025Observational
- The intricate relationship between capillary refill time and systemic hemodynamics in septic shock.Annals of intensive care · 2025Review
- Predictors of intradialytic hypotension in critically ill patients undergoing kidney replacement therapy: a systematic review.Intensive care medicine experimental · 2024Review
- The nuts and bolts of fluid de-escalation.Intensive care medicine · 2023Article
- Syndecan-1 predicts hemodynamic instability in critically ill patients under intermittent hemodialysis.Clinical kidney journal · 2023Article
- Capillary refill time for the management of acute circulatory failure: a survey among pediatric and adult intensivists.BMC emergency medicine · 2022Article
- Intra-dialytic hypotension following the transition from continuous to intermittent renal replacement therapy.Annals of intensive care · 2021Article
- Monitoring skin blood flow to rapidly identify alterations in tissue perfusion during fluid removal using continuous veno-venous hemofiltration in patients with circulatory shock.Annals of intensive care · 2021Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite improvements in intermittent hemodialysis management, intradialytic hemodynamic instability (IHI) remains a common issue that could account for increased mortality and delayed renal recovery. However, predictive factors of IHI remain poorly explored. The objective of this study was to evaluate the relationship between baseline macrohemodynamic, tissue hypoperfusion parameters and IHI occurrence.
methodsProspective observational study conducted in a 18-bed medical ICU of a tertiary teaching hospital. Cardiovascular SOFA score, index capillary refill time (CRT) and lactate level were measured just before (T0) consecutive intermittent hemodialysis sessions performed for AKI. The occurrence of IHI requiring a therapeutic intervention was recorded.
resultsTwo hundred eleven sessions, corresponding to 72 (34%) first sessions and 139 (66%) later sessions, were included. As IHI mostly occurred during first sessions (43% vs 12%, P < 0.0001), following analyses were performed on the 72 first sessions. At T0, cardiovascular SOFA score ≥1 (87% vs 51%, P = 0.0021) was more frequent before IHI sessions, as well as index CRT ≥ 3 s (55% vs 15%, P = 0.0004), and hyperlactatemia > 2 mmol/L (68% vs 29%, P = 0.0018). Moreover, the occurrence of IHI increased with the number of macrohemodynamic and tissue perfusion impaired parameters, named SOCRATE score (cardiovascular SOFA, index CRT and lactATE): 10% (95% CI [3%, 30%]), 33% (95% CI [15%, 58%]), 55% (95% CI [35%, 73%]) and 80% (95% CI [55%, 93%]) for 0, 1, 2 and 3 parameters, respectively (AUC = 0.79 [0.69-0.89], P < 0.0001). These results were confirmed by analyzing the 139 later sessions included in the study.
conclusionsThe SOCRATE score based on 3 easy-to-use bedside parameters correlates with the risk of IHI. By improving risk stratification of IHI, this score could help clinicians to manage intermittent hemodialysis initiation in critically ill AKI patients.
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