Dose of Continuous Renal Replacement Therapy in Critically Ill Patients: A Bona Fide Quality Indicator

Vásquez-Jiménez, Enzo; Anumudu, Samaya; Neyra, Javier A.

doi:10.1159/000512846

Cited by 18 publications

(14 citation statements)

References 55 publications

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“…e score of the anxiety and depression scales was proportional to the severity of the anxiety and depression. A higher WHOQOL-BREF score directly results in a better quality of life [7,8]. WHOQOL-BREF includes physical health, mental state, independent ability, social relations, personal beliefs, and surrounding environment in six areas and 24 aspects.…”

Section: Outcome Measurementsmentioning

confidence: 99%

Research on the Application Effect of Strengthening Risk Management in Continuous Renal Replacement Therapy Nursing of Critically Ill Patients

Yang

Chen

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the efficacy of risk management in the nursing of critically ill patients on continuous renal replacement therapy (CRRT). Methods. In this retrospective study, 80 critically ill patients on continuous renal replacement therapy in our hospital from February 2020 to February 2021 were recruited. They were randomly assigned to receive either the risk management treatment (risk management group) or the conventional management treatment (conventional management group) via the random number table method. Outcome measurements included the occurrence of adverse events, complications, psychological status, quality of life, treatment compliance, duration of CRRT, and nursing satisfaction. Results. Risk management treatment was associated with lower incidence of adverse events compared to conventional management treatment ( P value < 0.05). The risk management group also resulted in a lower incidence of complications compared to the conventional management group ( P value < 0.05). Patients who received risk management treatments demonstrated a significantly lower anxiety/depression level and a higher World Health Organization Quality of Life Brief Version (WHOQOL-BREF) ( P value < 0.05). The risk management group resulted in more cases with high compliance and fewer cases with moderate and poor compliance ( P < 0.05 ). Risk management was associated with more cases with a CRRT duration less than 36 hours and 36–48 hours and fewer cases with a duration longer than 48 h (X2 = 2.999, P value < 0.05). Patients who were given a risk management treatment had a higher nursing satisfaction compared to conventional management treatment (X2 = 4.501, P value < 0.05). Conclusion. Risk management treatment in caring of critically ill patients on CRRT shows better efficacy than conventional management treatments.

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Section: Outcome Measurementsmentioning

confidence: 99%

Research on the Application Effect of Strengthening Risk Management in Continuous Renal Replacement Therapy Nursing of Critically Ill Patients

Yang

Chen

2022

Evidence-Based Complementary and Alternative Medicine

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“…In addition, Brazil is the third country in the world in the number of patients requiring dialysis in the long term [ 4 ]. In CKD, changes in glomerular filtration rates, whether or not associated with parenchymal changes, for more than 3 months [ 5 , 6 ] require treatment via renal replacement therapy by peritoneal dialysis or hemodialysis (HD) for maintaining homeostasis and increasing patient survival [ 7 ]. However, in several countries, HD is an experience that influences the quality of life and can be painful [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Pain in Hemodialysis Patients: Prevalence, Intensity, Location, and Functional Interference in Daily Activities

et al. 2021

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Although pain is a frequent complaint of patients with chronic kidney disease who undergo hemodialysis, few studies have assessed the functional interference of pain in activities of daily living (ADLs). Hence, the aim of this study was to evaluate the prevalence, location, intensity, and functional interference of pain in ADLs of chronic kidney disease patients undergoing hemodialysis and to estimate the association of specific pain sites with severe functional interference by pain in ADLs. This cross-sectional study included patients with chronic kidney disease undergoing hemodialysis. The prevalence, intensity, and functional interference of pain in ADLs were assessed using the brief pain inventory. Poisson regression was used to calculate the prevalence ratio. A total of 65 patients participated in the study. The overall prevalence of pain was 89.23%; the prevalence of headache was 18.46% and that of pain in the trunk was 55.38%, upper limbs was 35.38%, and lower limbs was 60.00%. The prevalence of moderate and severe pain at the time of hemodialysis was 13.85% and 21.54%, respectively. A high prevalence of severe functional interference of pain in general activity (61.54%), mobility (56.92%), and disposition (55.38%) was observed. Pain is a frequent complaint in patients undergoing hemodialysis, mainly musculoskeletal and intradialytic, and it interferes with ADLs and incapacitates the patient. Pain was highly prevalent in the upper and lower limbs and the trunk. Furthermore, a higher prevalence of severe pain at the time of hemodialysis and functional interference of pain, mainly in general activity, mobility, and disposition, were observed.

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“…Similar to the % gap between prescribed vs. achieved total effluent dose of CRRT [ 23 ], %FB Gap is an important CRRT quality indicator that should be systematically and dynamically monitored throughout the delivery of CRRT [ 24 ]. For example, a recent report by the Acute Disease Quality Initiative group recommended that %FB Gap should be less than 20% on average.…”

Section: Discussionmentioning

confidence: 99%

Assessment of prescribed vs. achieved fluid balance during continuous renal replacement therapy and mortality outcome

et al. 2022

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Background Fluid management during continuous renal replacement therapy (CRRT) requires accuracy in the prescription of desired patient fluid balance (FBGoal) and precision in the attainable patient fluid balance (FBAchieved). Herein, we examined the association of the gap between prescribed vs. achieved patient fluid balance during CRRT (%FBGap) with hospital mortality in critically ill patients. Methods Cohort study of critically ill adults with acute kidney injury (AKI) requiring CRRT and a prescription of negative fluid balance (mean patient fluid balance goal of negative ≥0.5 liters per day). Fluid management parameters included: 1) NUF (net ultrafiltration rate); 2) FBGoal; 3) FBAchieved; and 4) FBGap (% gap of fluid balance achieved vs. goal), all adjusted by patient’s weight (kg) and duration of CRRT (hours). Results Data from 653 patients (median of 102.2 patient-hours of CRRT) were analyzed. Mean (SD) age was 56.7 (14.6) years and 61.9% were male. Hospital mortality rate was 64%. Despite FBGoal was similar in patients who died vs. survived, survivors achieved greater negative fluid balance during CRRT than non-survivors: median FBAchieved -0.25 [-0.52 to -0.05] vs. 0.06 [-0.26 to 0.62] ml/kg/h, p<0.001. Median NUF was lower in patients who died vs. survived: 1.06 [0.63–1.47] vs. 1.22 [0.82–1.69] ml/kg/h, p<0.001, and median %FBGap was higher in patients who died (112.8%, 61.5 to 165.7) vs. survived (64.2%, 30.5 to 91.8), p<0.001. In multivariable models, higher %FBGap was independently associated with increased risk of hospital mortality: aOR (95% CI) 1.01 (1.01–1.02), p<0.001. NUF was not associated with hospital mortality when adjusted by %FBGap and other clinical parameters: aOR 0.96 (0.72–1.28), p = 0.771. Conclusions Higher %FBGap was independently associated with an increased risk of hospital mortality in critically ill adults with AKI on CRRT in whom clinicians prescribed negative fluid balance via CRRT. %FBGap represents a novel quality indicator of CRRT delivery that could assist with operationalizing fluid management interventions during CRRT.

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Dose of Continuous Renal Replacement Therapy in Critically Ill Patients: A Bona Fide Quality Indicator

Cited by 18 publications

References 55 publications

Research on the Application Effect of Strengthening Risk Management in Continuous Renal Replacement Therapy Nursing of Critically Ill Patients

Research on the Application Effect of Strengthening Risk Management in Continuous Renal Replacement Therapy Nursing of Critically Ill Patients

Pain in Hemodialysis Patients: Prevalence, Intensity, Location, and Functional Interference in Daily Activities

Assessment of prescribed vs. achieved fluid balance during continuous renal replacement therapy and mortality outcome

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