Circuit life span of continuous renal replacement therapy in critically ill patients with or without conventional anticoa-gulation: an observational prospective study

Approximately 10% of the critically ill patients required renal replacement therapy (RRT). 1 Continuous renal replacement therapy (CRRT) is the most commonly used RRT modality in critical care setting. 2,3 In order to maintain adequate patency of the extracorporeal circuit and the performance of the filter, anticoagulation is usually needed for CRRT. 4 However, critically ill patients are commonly associated with coagulation abnormalities, including thrombocytopenia, prolonged prothrombin time (PT), and activated partial thromboplastin time (APTT), and decreased antithrombin or protein C, which indicate high risk of bleeding. [5][6][7][8] The increased bleeding risk contributed to the hesitation of anticoagulant use for CRRT in clinical practice. A worldwide survey demonstrated that approximately one third of patients did not receive any anticoagulants during CRRT. 9 The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline recommended CRRT without anticoagulation in patients with contraindication to citrate and increased bleeding risk. 10 Nevertheless, compared to circuits managed with anticoagulation, the averaged circuit lifespan of anticoagulation-free CRRT was significantly shorter. 11 Premature circuit failure due to clotting could lead to blood loss, decreased therapeutic efficacy, and increased medical workload and costs. 4,12,13 However, in some patients with prolonged APTT and/or thrombocytopenia, anticoagulation-free CRRT could proceed effectively. 14 The efficacy of anticoagulation-free CRRT

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Continuous renal replacement therapy without anticoagulation in critically ill patients at high risk of bleeding: A systematic review and meta‐analysis

Zhang

Bai

et al. 2021

Seminars in Dialysis

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Factores asociados a la duración del hemofiltro en técnicas continuas de depuración extracorpórea en el paciente ingresado en cuidados intensivos

Tomé¹,

Palau²,

Jiménez³

et al. 2021

Enferm Nefrol

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Objetivos: Determinar la vida media de los hemofiltros en el paciente crítico ingresado en la UCI y los principales factores asociados a su duración. Metodología: Estudio descriptivo observacional transversal, realizado en una Unidad de Cuidados Intensivos de adultos polivalente. Se estudiaron los hemofiltros colocados en 67 pacientes mayores de 18 años, entre enero y noviembre de 2019. Variables: edad, sexo, peso, unidad de ingreso, velocidad de flujo sanguíneo, fracción de filtrado, débito horario, anticoagulación del sistema, tiempo de tromboplastina activada (TTPA), indicación médica de la terapia, causa de la retirada, localización del catéter, hora de inicio y finalización de la terapia. Resultados: La edad media de los pacientes fue de 62,66 años (±9,95), 81 (71,64%) hombres. Se analizaron un total de 238 hemofiltros con una vida media de 26,28 horas (±22,8). El 80,1 % de los catéteres fueron femorales, el 19% yugulares y el 0,8% subclavios. Se empleó como terapia de anticoagulación, heparina sódica en un 45,8%, citratos en el 20,2% y en un 34% no se utilizó anticoagulación. La velocidad media de flujo sanguíneo fue de 190,08 ml/min (±53,48). Se encontró relación estadística entre las variables flujo sanguíneo (rs=0,208; p=0,001), localización del catéter y duración del hemofiltro (p=0,03). Conclusiones: La vida media del hemofiltro fue de 26 horas. La velocidad del flujo sanguíneo y localización del catéter son factores que repercuten en la duración del hemofiltro.

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Circuit life span of continuous renal replacement therapy in critically ill patients with or without conventional anticoa-gulation: an observational prospective study

Abstract: artículos originales breves0 supervivencia de circuitos de técnicas de depuración extrarrenal continua en pacientes críticos con o sin anticoagulación convencional: estudio observacional prospectivo

Cited by 2 publications

References 5 publications

Continuous renal replacement therapy without anticoagulation in critically ill patients at high risk of bleeding: A systematic review and meta‐analysis

Continuous renal replacement therapy without anticoagulation in critically ill patients at high risk of bleeding: A systematic review and meta‐analysis

Factores asociados a la duración del hemofiltro en técnicas continuas de depuración extracorpórea en el paciente ingresado en cuidados intensivos

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