Standardization of continuous renal-replacement therapy fluids using a commercial product

Godden, Jon; Spexarth, Frank; Dahlgren, Melissa

doi:10.2146/ajhp110325

Cited by 3 publications

(3 citation statements)

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“…Such variable in turn depends on solute concentration (citrate, in this case) with respect to the therapeutic dose. The solute concentration is an important variable that might be standardized (see [16]) with respect to the therapeutic doses in order to contribute to consumption and cost reduction.…”

Section: Resultsmentioning

confidence: 99%

“…The clinicians may include in their choices considerations about personnel management, easiness, and readiness of laboratory analysis and waste disposal. Since the BoM takes into account all the costs detailed above, it may be an efficient tool to guide the internal activities of the suppliers who, in turn, may invest in research and development to obtain more efficient BoMs to submit to the public service [16]. Such types of analyses allow the suppliers to enter the process supply chain and take advantage of their own ability in competitive cost reduction.…”

Section: Resultsmentioning

confidence: 99%

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Cost analysis of blood purification: a tool for decision-making and supply chain optimization

Grazzini

Razzauti

Galatà³

et al. 2019

Ren Replace Ther

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This study complies with the reorganization of health care provider processes based on the cost of life cycle of the product. The aim is to determine the costs of treatment administration of extracorporeal dialysis and other treatments in extracorporeal systems. The strategy here was to apply for the first time the "bill of material" (BoM) method to the production and management of the services above. By using standard replacement flows, we build the "bill of materials" to calculate the cost of a CRRT (continuous renal replacement therapy) with anticoagulant. The standard cost of the process is thus obtained. The method here developed can be used for accounting purposes and for economic planning, as a tool for accurate statistical evaluation of medical care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cost analysis of blood purification: a tool for decision-making and supply chain optimization

Grazzini

Razzauti

Galatà³

et al. 2019

Ren Replace Ther

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show abstract

“…Despite the efforts to prevent electrolyte disturbance during CRRT, there is no standardized protocol for choosing dialysate and replacement fluids. Various studies have been conducted to improve the quality of CRRT operation and to develop standardized guidelines ( 17 , 18 ). An evidence-based approach and multidisciplinary communication on CRRT application were reported to reduce the duration of CRRT and medical costs ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of protocolized fluid management on electrolyte stability in patients undergoing continuous renal replacement therapy

et al. 2022

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ObjectiveContinuous renal replacement therapy (CRRT) is the standard treatment for critically ill patients with acute kidney injury (AKI). Electrolyte disturbance such as hypokalemia or hypophosphatemia occurs paradoxically in patients undergoing CRRT due to high clearance. We developed a fluid management protocol for dialysate and replacement fluid that depends on serum electrolytes and focuses on potassium and phosphate levels to prevent electrolyte disturbance during CRRT. The impact of our new fluid protocol on electrolyte stability was evaluated.MethodsAdult patients who received CRRT between 2013 and 2017 were included. Patients treated 2 years before (2013–2014; pre-protocol group) and 2 years following development of the fluid protocol (2016–2017; protocol group) were compared. The primary outcomes were individual coefficient of variation (CV) and abnormal event rates of serum phosphate and potassium. Secondary outcomes were frequency of electrolyte replacement and incidence of cardiac arrhythmias. Individual CV and abnormal event rates for each electrolyte were analyzed using the Wilcoxon rank-sum test and Chi-square test with Yates’ continuity correction.ResultsA total of 1,448 patients was included. Both serum phosphate and potassium were higher in the protocol group. The CVs of serum phosphate (pre-protocol vs. protocol, 0.275 [0.207–0.358] vs. 0.229 [0.169–0.304], p < 0.01) and potassium (0.104 [0.081–0.135] vs. 0.085 [0.064–0.110], p < 0.01) were significantly lower in the protocol group. The abnormal event rates of serum phosphate (rate [95% CI], 0.410 [0.400–0.415] vs. 0.280 [0.273–0.286], p < 0.01) and potassium (0.205 [0.199–0.211] vs. 0.083 [0.079–0.087], p < 0.01) were also significantly lower in the protocol group.ConclusionThe protocolized management of fluid in CRRT effectively prevented hypophosphatemia and hypokalemia by inducing excellent stability of serum phosphate and potassium levels.

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Recent Publications on Medications and Pharmacy

Russett¹

2012

Hosp Pharm

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Standardization of continuous renal-replacement therapy fluids using a commercial product

Abstract: The standardization of CRRT fluids using commercially available products improved a medical center's compliance with patient safety standards and yielded substantial cost savings.

Cited by 3 publications

References 9 publications

Cost analysis of blood purification: a tool for decision-making and supply chain optimization

Cost analysis of blood purification: a tool for decision-making and supply chain optimization

Impact of protocolized fluid management on electrolyte stability in patients undergoing continuous renal replacement therapy

Recent Publications on Medications and Pharmacy

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