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Abstract: PO0862

The Introduction of Quanta SC+ to Critical Care for Haemodialysis During the COVID-19 Pandemic

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Rechner, Ian, Royal Berkshire NHS Foundation Trust, Reading, Reading, United Kingdom
  • Mcmullen, Ria D., Royal Berkshire NHS Foundation Trust, Reading, Reading, United Kingdom
  • Clarke, Angela M., Berkshire Kidney Unit, Royal Berkshire NHS Foundation Trust, Reading, Berkshire, United Kingdom
  • Boore, Bernice G., Berkshire Kidney Unit, Royal Berkshire NHS Foundation Trust, Reading, Berkshire, United Kingdom
  • Vaux, Emma C., Berkshire Kidney Unit, Royal Berkshire NHS Foundation Trust, Reading, Berkshire, United Kingdom
Background

Of 800 patients treated annually in 19 ICU beds (catchment 500,000) 120 require renal replacement therapy (RRT) delivered by Baxter Prismaflex® (continuous veno-veno haemodiafiltration (CVVHDF)). With the onset of the COVID19 pandemic significant increased incidence of acute kidney injury (AKI) requiring RRT & existing intermittent haemodialysis (IHD) patients contracting COVID19 requiring ICU support raised concerns regarding RRT ICU capacity. Additionally a worrying national shortage of CVVHF/HDF consumables & new machines to deliver this requirement; all critical drivers to seek local solutions for RRT provision beyond usual capability

Methods

A kidney unit neighbour described their successful experience trialling SC+ in home IHD patients. Translation of SC+ from home use to safe IHD treatment in ICU was quickly apparent alongside ease of supporting technical infrastructure set up & minimal training requirements. Immediate availability & fiscal acceptability of purchasing 4 Quanta SC+ and 2 supporting RO machines were critical determinants in making IHD a realistic & sustainable solution to desperate RRT shortages. Provision of expert technical support and clinical nurse specialist facilitation expedited training of ICU workforce & enabled swift implementation

Results

27 ICU nurses were trained in 3 weeks (23 in 14 days). Between 22/4/20 & 17/5/20 8 patients (range 37-63 yrs, median 53.5; 7/8 known IHD, 1/8 AKI; 7/8 COVID19 positive) received 20 treatments (1-5/patient) using SC+ in ICU. An agreed ICU IHD protocol was co-designed gaining consensus in an unfamiliar territory of provision of IHD in ICU & differing clinical perspectives in IHD prescription in a critical care setting

Conclusion

At a time of unprecedented national shortage of dialysis machines & increased RRT need associated with COVID19, Quanta provided an effective solution for safe provision of IHD in ICU. Ease of use with training delivered in <6 hours enabled ICU nurses to effectively treat patients independent of dialysis nurses allowing continuity of the chronic HD programme. Learnings identified the importance of training, enabling rapid growth of a critical mass of expertise & confidence. Critical elements included mastering unfamiliar technique, establishing infrastructure, procurement & team communication enabled by online & face-to-face troubleshooting support

Funding

  • Commercial Support