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NCT Number: NCT07005531

Ultrasound-Guided Microbubble Removal and Filter Lifespan During CRRT: A Pilot Crossover Study

What is this study about? This study is designed to evaluate whether ultrasound-guided removal of microbubbles during circuit priming in Continuous Renal Replacement Therapy (CRRT) can extend the filter lifespan for critically ill patients who require CRRT. The investigators aim to determine if this technique improves the duration of effective filter use and reduces complications related to filter clotting.

Who can join? Adults (18 years or older) admitted to the Intensive Care Unit (ICU) and diagnosed with acute kidney injury (AKI) or chronic kidney failure (CKD) who require CRRT and are expected to undergo at least two sessions of CRRT treatment.

Participants or their legal representatives must provide signed informed consent.

Who cannot join? Patients with severe coagulation disorders, platelet count <30×10^9/L, contraindications to anticoagulation, significant changes in clinical scores or blood tests between CRRT sessions, or any other condition deemed unsuitable by the investigator.

What will happen during the study?

Two Treatment Methods:

Conventional Priming (Control): The CRRT circuit will be primed following the standard visual bubble inspection protocol.

Ultrasound-Guided Priming (Intervention): The circuit will be primed using real-time ultrasound to detect and remove microbubbles from key locations.

Each participant will receive both interventions in random order, separated by a washout period of at least 24 hours.

Safe and Routine Monitoring:

Ultrasound scans will be performed on the filter and circuit to guide microbubble removal.

Standardized CRRT treatment protocols, including filter type and anticoagulation regimen, will be used for all sessions.

Other Data Collection:

Patient information (e.g., age, sex, medical history, APACHE II score) CRRT treatment details (e.g., filter lifespan, filter clotting incidence, coagulation parameters) Monitoring of adverse events and clinical outcomes (including 28-day survival and treatment costs) What are the benefits and risks? Benefits: This study may provide evidence for a simple, non-invasive method to reduce filter clotting, improve CRRT efficiency, and enhance patient outcomes.

Risks: Ultrasound monitoring is non-invasive and does not add risk beyond standard care. All procedures are standard clinical practice.

Your Rights and Safety Voluntary Participation: Participation is voluntary; withdrawal is allowed at any time without affecting clinical care.

Ethical Approval: The study protocol is reviewed and approved by the hospital's ethics committee.

Confidentiality: All personal information and test results will be kept confidential.

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age ≥18 years, regardless of sex;
  • Admission to the intensive care unit (ICU) with a diagnosis of acute kidney injury (AKI) or chronic kidney disease (CKD) requiring continuous renal replacement therapy (CRRT);
  • Expected to receive at least two sessions of CRRT;
  • Written informed consent obtained from the patient or their legally authorized representative.

Exclusion criteria

  • Presence of severe coagulopathy (such as disseminated intravascular coagulation, DIC) or platelet count <30×10^9/L;
  • Contraindications to anticoagulation therapy;
  • Change in APACHE II score >5 points, or changes in coagulation parameters and platelet count exceeding 20% between the two treatment sessions;
  • Any other condition deemed unsuitable for participation by the investigators.

Treatment and study plan

Ultrasound-Guided Microbubble Clearance During Circuit Priming

Procedure

CRRT circuits will be primed under real-time ultrasound monitoring. A portable ultrasound probe will be used to scan key points in the circuit and filter to detect and guide the removal of residual microbubbles before treatment. The process is considered complete when three consecutive scans (at 2-minute intervals) show no detectable microbubbles.

Primary outcomes

  1. Filter Lifespan

    Time frame: For each CRRT session, up to a maximum of 72 hours per session.

    Time (in hours) from the start of CRRT treatment to filter failure (defined as filter clotting requiring replacement, or completion of prescribed treatment).

  2. Feasibility of Ultrasound-Guided Microbubble Clearance

    Time frame: Peri-procedural (from initiation to completion of each CRRT session)

    Feasibility will be evaluated by the proportion of CRRT sessions in which microbubble clearance is completed according to predefined ultrasound scanning criteria (three consecutive scans at 10-minute intervals without detectable microbubbles). Assessment is based on procedure documentation and saved ultrasound images.

Secondary outcomes

  1. Incidence of Filter Clotting

    Time frame: For each CRRT session, up to a maximum of 72 hours per session.

    Number and proportion of CRRT circuits with filter clotting events requiring early replacement.

  2. 28-Day Survival Rate

    Time frame: Day 28 after enrollment.

    Proportion of patients surviving at 28 days after enrollment.

Study contacts

Contact information is provided by the study sponsor or research team.

Qiancheng Xu

CONTACT

[email protected]

86-18297529106

Sponsors and collaborators

Lead sponsor

First Affiliated Hospital of Wannan Medical College

Other

Registry information

Official study title

Impact of Ultrasound-Guided Microbubble Clearance During CRRT Circuit Priming on Filter Lifespan: A Randomized Crossover Pilot Trial

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jun 5, 2025
Registry last updated
Jun 5, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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