Search

Abstract Background Critically ill patients frequently develop acute kidney injury that necessitates renal replacement therapy (RRT). At some centers, critically ill patients who are hemodynamically unstable and require RRT are treated with slow low-efficiency dialysis (SLED). Unfortunately, hypotension is a frequent complication that occurs during SLED treatments and may limit the recovery of kidney function. Hypotension may also limit the amount of fluid that can be removed by ultrafiltration with SLED. Fluid overload can be exacerbated as a consequence, and fluid overload is associated with increased mortality. Occasionally, intravenous albumin fluid is given to prevent or treat low blood pressure during SLED. The intent of doing so is to increase the colloid oncotic pressure in the circulation to draw in extravascular fluid, increase the blood pressure, and enable more aggressive fluid removal with ultrafiltration. Nonetheless, there is little evidence to support this practice and theoretical reasons why it may not be especially effective at augmenting fluid removal in critically ill patients. At the same time, albumin fluid is expensive. As such, we present a protocol for a study to assess the feasibility of a randomized controlled trial evaluating the use of albumin fluid versus saline in critically ill patients receiving SLED. Methods This study is a single-center, double-blind, and randomized controlled pilot trial with two parallel arms. It involves randomly assigning patients receiving SLED treatment in the ICU to receive either albumin (25%) boluses or normal saline fluid boluses (placebo) to prevent and treat low blood pressure. Discussion The results of this pilot trial will help with planning a larger trial comparing the efficacy of the interventions in achieving fluid removal in critically ill patients with AKI on SLED. They will establish whether enough participants would participate in a larger study and accept the study procedures. Trial registration This trial is registered on ClinicalTrials.gov Identifier NCT03665311, registered on September 11, 2018.

• SDS stabilizer and ultrasonication gives better dispersion of GNP in Saline media. • The surface tension of GNP-Saline nanofluids decreases with temperature. • A maximum decrease of 21 % in surface tension is found by adding GNP is saline media. • Increase in GNP wt% (0.05 - 0.25) in nanofluid have no impact on surface tension. The dispersions of engineered nanomaterials in fluids have envisioned numerous industrial applications. Despite less experimental data available on the surface tension of nanofluids, it is one of the critical parameters to define thermal configurations and two-phase transport properties. This study focuses on the benchmark experimental investigation of the surface tension behavior in graphene nanoplatelets-based saline nanofluids in ambient air using the pendant drop method. Graphene nanoplatelets are dispersed in saline fluid (30PPT) using optimum anionic SDS stabilizer and ultrasonication, exhibiting excellent stability for minimum 72 h. Different characterizations are performed for nanoplatelets and nanofluid stability such as electron microscopy, FTIR, XRD, DLS and sedimentation analysis. Surface tension measurements are taken at varying concentrations of graphene nanoplatelets range of 0-0.25 wt% and temperature range of 25−65 °C. The obtained results from this research exhibit that the addition of nanoplatelets drops the surface tension of saline fluid by 21 %. However, the increase in concentration from 0.05 wt% to 0.25 wt% does not have a considerable implication on the overall surface tension behavior. It is observed that the surface tension of the saline fluid and the nanofluid decrease with the elevation in temperature. [ABSTRACT FROM AUTHOR]

Background: Critically ill patients frequently develop acute kidney injury that necessitates renal replacement therapy (RRT). At some centers, critically ill patients who are hemodynamically unstable and require RRT are treated with slow low-efficiency dialysis (SLED). Unfortunately, hypotension is a frequent complication that occurs during SLED treatments and may limit the recovery of kidney function. Hypotension may also limit the amount of fluid that can be removed by ultrafiltration with SLED. Fluid overload can be exacerbated as a consequence, and fluid overload is associated with increased mortality. Occasionally, intravenous albumin fluid is given to prevent or treat low blood pressure during SLED. The intent of doing so is to increase the colloid oncotic pressure in the circulation to draw in extravascular fluid, increase the blood pressure, and enable more aggressive fluid removal with ultrafiltration. Nonetheless, there is little evidence to support this practice and theoretical reasons why it may not be especially effective at augmenting fluid removal in critically ill patients. At the same time, albumin fluid is expensive. As such, we present a protocol for a study to assess the feasibility of a randomized controlled trial evaluating the use of albumin fluid versus saline in critically ill patients receiving SLED. Methods: This study is a single-center, double-blind, and randomized controlled pilot trial with two parallel arms. It involves randomly assigning patients receiving SLED treatment in the ICU to receive either albumin (25%) boluses or normal saline fluid boluses (placebo) to prevent and treat low blood pressure. Discussion: The results of this pilot trial will help with planning a larger trial comparing the efficacy of the interventions in achieving fluid removal in critically ill patients with AKI on SLED. They will establish whether enough participants would participate in a larger study and accept the study procedures. Trial registration: This trial is registered on ClinicalTrials.gov Identifier NCT03665311, registered on September 11, 2018. [ABSTRACT FROM AUTHOR]