Abstract: PO0249
Clinical Factors Affecting Continuous Renal Replacement Therapy Circuit Life Span
Session Information
- AKI: Clinical, Outcomes, and Trials
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Kim, Jae seok, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Shin, Hanwul, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Yoojin, Kim, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Lee, Jun Young, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Yang, Jae Won, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Han, Byoung Geun, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
- Choi, Seung-Ok, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
Background
CRRT is a useful dialysis modality in hemodynamically unstable patients. But despite use of anticoagulants, clotting of CRRT circuit frequently occurs, which reduces the efficiency of dialysis. In the study, we aim to investigate the clinical factors contributing to CRRT circuit clotting.
Methods
The medical records of total 119 critically ill patients requiring CRRT were reviewed retrospectively. We investigated the clinical factors affecting the time from CRRT start to first dialysis circuit clotting, and the proportion of dialysis circuit changes due to clotting to total circuit changes during entire CRRT periods.
Results
Un-tunneled femoral hemodialysis catheter had a shorter time to first circuit clotting (22.8 vs. 32.1 hours, p=0.013), and a higher rate of circuit clotting (69.3 vs. 52.6 %, p=0.043) than jugular catheter. The time to first circuit clotting had a negative correlation with norepinephrine dosage (r= -0.335, p=0.002) and serum creatinine level (r= -0.402, p<0.001), while it had a positive correlation with arterial blood ionized calcium (r=0.273, p=0.017). In multiple regression analysis, it was confirmed that high norepinephrine dosage and high serum creatinine contributed to circuit clotting, and of which serum creatinine was the most significant contributing factor to circuit lifespan (Table 1). During entire CRRT periods, the proportion of dialysis circuit changes due to clotting was well negatively correlated with the time to first circuit clotting (r= -0.460, p<0.001), and total duration of CRRT application (r= -0.306, p=0.006). However, neither transfusion nor CRRT parameters such as blood flow and filtration fraction had no relationship with circuit survival.
Conclusion
Conclusively, in regard to CRRT circuit lifespan, femoral hemodialysis catheter, high norepinephrine dosage, and especially high serum creatinine level contributed to CRRT circuit clotting.
Multiple regression analysis on the time to first CRRT circuit clotting
| Model 2 | B | Std. Error | Beta | t | p value |
| (Constant) | 34.979 | 4.420 | 7.941 | 0.000 | |
| NE dosage | - 0.164 | 0.069 | - 0.296 | - 2.368 | 0.022 |
| Serum Cr | - 3.007 | 1.339 | - 0.281 | - 2.246 | 0.029 |
Std: standard; NE: norepinephrine; Cr: creatinine