- 期刊
- OpenAccess
Factors Associated With Circuit Set Lifetime in Continuous Venovenous Hemofiltration Therapy
摘要
BACKGROUND: Continuous renal replacement therapy (CRRT) success depends on the maintenance of a clear fl owing filter and circuitry. Here, we investigated factors associated with filter/circuit set lifetime during CRRT. METHODS: We studied 49 patients who underwent continuous venovenous hemofiltration (CVVH) between December 2016 and July 2018. Details of the CVVH procedure and biochemistry and hemogram results were collected from medical records. Data from a total of 114 filter/circuit sets were analyzed. RESULTS: The average lifetime of the filter/circuit set was 33.2 ± 22.0 hours. Univariate analysis showed that filter lifetime was positively correlated with activated clotting time (ACT) and the number of units of packed red blood cell transfused. Filter lifetime was negatively correlated with filtration fraction (FF), Acute Physiologic Assessment and Chronic Health Evaluation II score, and serum creatinine level. Multivariate analysis demonstrated that FF (β = -0.389, P = 0.001) and ACT (β = 0.491, P ＜ 0.001) were the two independent factors associated with filter lifetime. Compared to the filters with an FF ≥ 30%, those with an FF ＜ 30% had a significantly higher 24-hour survival (odds ratio, 2.49; 69% vs. 47%; P = 0.045). Compared to the filters with an ACT ＜ 180 seconds, those with an ACT of 180-200 seconds had a significantly higher 24-hour filter survival (odds ratio, 2.63; 58% vs. 35%; P = 0.047). CONCLUSION: FF and ACT are independent factors associated with filter lifetime in CVVH. Our real-world data confirm that an FF less than 30% and target ACT of 180-200 seconds are keys to maintaining a filter lifetime longer than 24 hours in CVVH. Our findings warrant further confirmation in larger populations and may offer new understanding of and therapeutic strategies for CRRT in critically ill patients.
延伸閱讀
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