Clinical Survey of Decreased Blood Flow Rate in Continuous Renal Replacement Therapy: A Retrospective Observational Study

Abstract

Background Continuous renal replacement therapy (CRRT) is an essential procedure for patients with acute kidney injury in intensive care. It is important to maintain an adequate blood flow rate during CRRT. Several previous studies have reported the relationships between blood flow rate and filter lifespan, or circuit life, in CRRT. Here, we aim at elucidating the incidence and factors associated with a decreased blood flow rate in CRRT. Methods This is a retrospective observational study. From January 2014 to June 2017, 119 patients who underwent CRRT in the intensive care unit were enrolled. The definition of a decreased blood flow rate included situations in which the medical staff needed to decrease the blood flow volume. We statistically analyzed the association of the decreased blood flow rate with patients' clinical characteristics. Results Of 119 patients, 52 required a decreased blood flow rate during CRRT. Almost half of the cases occurred within one day of starting CRRT. None of the clinical factors (age, sex, height, sequential organ failure assessment (SOFA) score, catheter position, systemic infection, albumin, hemoglobin, and activating coagulation time) were significantly associated with decreased blood flow rate. Conclusions A decreased blood flow rate often occurs during CRRT. Clinical factors significantly associated with the occurrence of the decreased blood flow rate were not detected in the current study. Further investigation regarding the occurrence of a decreased blood flow is warranted.

Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy

“… 21 , 22 A retrospective observational clinical survey from Japan also found sepsis (32.8 %) or severe infectious disease as the main reason for initiating CRRT, followed by heart failure (28.6 %), surgery (21 %), hepatic failure (1.7 %) and renal failure (4.2 %). 23 In contrast, acute coronary syndrome with cardiogenic shock (30.2 %) was the major cause of AKI in our study. An Indian study also reported that out of 22 patients who were due for CRRT, sepsis was present in 68.2%, CKD in 36.4% and diabetes in 27.3%.…”

Uptake of oxidative stress-mediated extracellular vesicles by vascular endothelial cells under low magnitude shear stress

“…Besides the varying levels of shear stress, different flow patterns are also present in the dynamic environment of the bloodstream [ 33 , 34 ]. To investigate the influence of uptake under different flow patterns, the parallel-plate flow chamber that can mimic the flow dynamics of vascular bifurcation or straight arteries was used to evaluate the uptake of RBCEVs by endothelial cells under normal shear stress with laminar flow (NSS) and OSS, respectively ( Fig.…”