Circuit Survival during Continuous Venovenous Hemodialysis versus Continuous Venovenous Hemofiltration

被引:22
作者
Califano, Alfonso Maria [1 ]
Bitker, Laurent [2 ,3 ]
Baldwin, Ian [2 ]
Fealy, Nigel [2 ]
Bellomo, Rinaldo [2 ,4 ]
机构
[1] Hosp del Mar, Dept Nephrol, Barcelona, Spain
[2] Austin Hosp, Dept Intens Care, 145 Studley Rd, Melbourne, Vic 3084, Australia
[3] Hosp Civils Lyon, Hop Croix Rousse, Serv Med Intens & Reanimat, Lyon, France
[4] Univ Melbourne, Ctr Integrated Crit Care, Melbourne, Vic, Australia
关键词
Continuous venovenous hemodialysis; Continuous renal replacement therapy; Circuit survival; Clotting; Anticoagulation; Acute kidney injury; RENAL REPLACEMENT THERAPY; CRITICALLY-ILL PATIENTS; HEPARIN ANTICOAGULATION; CITRATE; LIFE; TRIAL;
D O I
10.1159/000504037
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Continuous renal replacement therapy (CRRT) technique may affect circuit lifespan. A shorter circuit life may reduce CRRT efficacy and increase costs. Methods: In a before-and-after study, we compared circuit median survival time during continuous venovenous hemofiltration (CVVH) versus continuous venovenous hemodialysis (-CVVHD). We performed log-rank mixed effects univariate analysis and Cox mixed effect regression modeling to define predictors of circuit lifespan. Results: We compared 197 -CVVHD and 97 CVVH circuits in 39 patients. There was no overall difference in circuit lifespan. When no anticoagulation was used, median circuit survival time was shorter for CVVH circuits (5 h, 95% CI 3-7 vs. 10 h, 95% CI 8-13, p < 0.01). Moreover, CVVHD, lower platelets levels, and longer activated partial thromboplastin time independently predicted longer circuit median survival time. Conclusions: CVVHD is associated with longer circuit median survival time than CVVH when no anticoagulation is used and is an independent predictor of circuit survival.
引用
收藏
页码:281 / 288
页数:8
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