Cooling effect of continuous renal replacement therapy in critically ill patients

Yagi, Nobuya; Leblanc, Martine; Sakai, Ken; Wright, EJ; Ep, Paganini

doi:10.1016/s0272-6386(98)70078-2

Cited by 73 publications

(55 citation statements)

References 14 publications

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“…The hemodynamic changes appeared to be related to a fall in core temperature (114). Indeed, the heat loss that occurs during CRRT may result in mild hypothermia with an increase in systemic vascular resistance and venous tone (115) and thus provide an alternative explanation for the reported laudable hemodynamic effects of CRRT. It should be noted that the hemodynamic tolerance of IHD in critically ill patients was substantially improved after implementation of guidelines derived from chronic hemodialysis, including dialysate sodium modeling, ultrafiltration profiling, and cooling of dialysate (116).…”

Section: Intermittent Hemodialysis (Ihd) Versus Continuous Renal Replmentioning

confidence: 97%

Prevention and Treatment of Acute Renal Failure in Sepsis

Vriese

2003

Journal of the American Society of Nephrology

111

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Section: Intermittent Hemodialysis (Ihd) Versus Continuous Renal Replmentioning

confidence: 97%

Prevention and Treatment of Acute Renal Failure in Sepsis

Vriese

2003

Journal of the American Society of Nephrology

111

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“…Higher CRRT doses are associated with a higher incidence of hypothermia [32]. CRRT-induced body cooling is determined both by the time during which blood circulates outside the body and the contact with cold dialysate and/or replacement fluids.…”

Section: Heat and Energy Lossmentioning

confidence: 99%

“…CRRT-induced body cooling is determined both by the time during which blood circulates outside the body and the contact with cold dialysate and/or replacement fluids. Long-term body cooling may have unwarranted or potentially detrimental side effects such as energy loss, shivering with increased oxygen demand, vasoconstriction, impairment of leukocyte function, and coagulation disorders [32]. As a consequence, monitoring of body temperature is imperative.…”

Section: Heat and Energy Lossmentioning

confidence: 99%

“…As a consequence, monitoring of body temperature is imperative. If the incorporated CRRT heating system fails to maintain the desired core temperature, external heating aiming at a temperature above 37°C (and sometimes even close to 42°C) must be utilized [32]. Of note, cooling may beneficially affect hemodynamics and outcome in ICU patients [33].…”

Section: Heat and Energy Lossmentioning

confidence: 99%

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Nutritional and Metabolic Alterations during Continuous Renal Replacement Therapy

Honoré

Waele²,

Jacobs³

et al. 2013

Blood Purif

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Adequate feeding of critically ill patients under continuous renal replacement therapy (CRRT) remains a challenging issue. We performed a systematic search of the literature published between 1992 and 2012 using the quorum guidelines regarding nutrition in intensive care unit patients treated with CRRT. Daily recommended energy requirements during CRRT are between 25 and 35 kcal/kg with carbohydrates and lipids accounting for 60-70% and 30-40% of calorie intake, respectively. Daily protein needs range from 1.5 to 1.8 g/kg. Indirect calorimetry corrected for CRRT-induced CO₂ diversion should be used to more correctly match calorie intake to the real needs. This type of tool is not yet available but hopefully soon. Electrolyte deficit as well as overload have been described during CRRT but, in general, can be easily controlled. Although not strongly evidenced, consensus exists to supplement important micronutrients such as amino acids (glutamine), water-soluble vitamins and trace elements.

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“…Although newer dialysis systems are equipped with a blood warmer, up to half of CRRT patients can experience significant drops in body temperature due to the extracorporeal radiant heat losses (Finkel and Podoll, 2009;Yagi et al, 1998). The commercial TMS in this case achieves targeted body temperatures by varying the temperature of circulating water in the adhesive pads from 4°C to 42°C in response to body temperature measurements.…”

mentioning

confidence: 99%

Bullous Lesions After Use of a Commercial Therapeutic Hypothermia Temperature Management System: A Possible Burn Injury?

Wang

Wells²,

Rizk³

2013

Therapeutic Hypothermia and Temperature Management

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Therapeutic hypothermia (TH) is a novel technique for improving the likelihood of survival with good neurologic outcome after cardiopulmonary arrest. While commercial temperature management systems (TMS) are intended to facilitate cooling of the body during TH, their operation also involves body exposure to heat. We describe the case of a 72-year-old female postarrest patient who underwent TH using a commercial watercirculating TMS and concurrent continuous renal replacement therapy. The patient developed bullous lesions on the thigh and torso suspected to constitute a scald burn injury from the TMS. Clinicians must be aware of this important adverse event when providing TH, especially in the setting of concurrent hemodialysis therapy.

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Cooling effect of continuous renal replacement therapy in critically ill patients

Cited by 73 publications

References 14 publications

Prevention and Treatment of Acute Renal Failure in Sepsis

Prevention and Treatment of Acute Renal Failure in Sepsis

Nutritional and Metabolic Alterations during Continuous Renal Replacement Therapy

Bullous Lesions After Use of a Commercial Therapeutic Hypothermia Temperature Management System: A Possible Burn Injury?

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