Early Diuresis Following Colorectal Surgery

Overview

About this study

This study will assess if administration of a loop diuretic, specifically furosemide, to achieve euvolemia can safely reduce length of stay following colorectal surgery.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria

  • All elective colorectal surgeries (CRS) utilizing the enhanced recovery pathway (ERP)
  • The surgery involves resection

Exclusion Criteria

Exclusion Criteria for Randomization:

  • Surgeries involving intraoperative radiation
  • Ileostomy closures, when performed as the only surgical intervention
  • Surgeries involving multiple disciplines (e.g., colorectal plus general surgery, colorectal plus gynecology surgery) except for colorectal surgeries plus ureteral stent placements.
  • Chronic loop diuretic therapy (i.e., bumetanide, torsemide, furosemide, ethacrynic acid) including as needed administration of such therapy
  • Patients receiving dialysis
  • Creatinine clearance, calculated by the Cockcroft-Gault equation, less than 30 mL/min.
  • Inpatient prior to surgery
  • Allergy to furosemide
  • Allergy to sulfa drugs if the allergy involves anaphylactic reaction
  • Lack of serum creatinine concentration within 3 months preceding the surgery AND diagnosis of chronic kidney disease

Exclusion Criteria for Intervention (applies to both the intervention and control arm):

  • Patient's weight on POD #1 and POD #2 is less than preoperative weight.
  • Blood pressure criteria: systolic blood pressure criteria less than 90 mmHg or greater than 30 mmHg below baseline on POD #1 and/or POD #2 immediately prior to administration of study drug.
  • Complications within 48 hours of surgery
  • Abscess (infected fluid collection, treated with CT drainage)
  • Leak (defined by CT drainage or reoperation)
  • Wound infection (treated with either antibiotics and/or open packing)
  • Bowel obstruction (treated with reoperation)
  • Reoperation
  • Hemorrhage
  • Weight change since admission on POD #1: > 5 kg
  • Acute kidney injury on POD #1 and POD#2 defined as SCr increase ≥ 0.3 mg/dL or increase to ≥ 150% to 200% (1.5- to 2-fold) from baseline

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status

Rochester, Minn.

Mayo Clinic principal investigator

Ilya Danelich, Pharm.D., R.Ph.

Closed for enrollment

More information

Publications

Publications are currently not available

Study Results Summary

Not yet available

Supplemental Study Information

Not yet available

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CLS-20144054

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