Factors affecting continuous renal replacement therapy duration in critically ill patients: A retrospective study

Abstract

IntroductionThis study aimed to analyze the factors affecting continuous renal replacement therapy (CRRT) duration in critically ill patients and provide a reference for clinical treatment.Material and MethodsWe divided patients into regional citrate anti‐coagulation (RCA) and low‐molecular‐weight‐heparin (LMWH) groups according to the anti‐coagulation method and collected the relevant data, to analyze the factors associated with CRRT time.ResultsCompared with the LMWH group, the RCA group had a longer mean treatment time (55.36 ± 22.57 vs. 37.65 ± 27.09 h, p < 0.001), lower transmembrane pressure, and lower filter pressure, regardless of vascular access site. Multivariable linear regression analysis showed a significant correlation between anti‐coagulation patterns, filter pressure at CRRT discontinuation, nurses' level of intensive care unit experience, pre‐machine fibrinogen level, and CRRT time.ConclusionAnti‐coagulation is the most important factor affecting CRRT duration. Filter pressure, nurses' level of intensive care unit experience, and fibrinogen level also affecting CRRT duration.

Safety of Citrate Anticoagulation in CKRT: Monocentric Experience of a Dynamic Protocol of Calcium Monitoring

“…The most feared and potentially lethal complication of RCA is citrate accumulation, and its diagnosis remains relatively complex in the absence of citrate blood level monitoring, a specific protocol for the patient’s total and ionized calcium monitoring, and trained personnel for the treatment administration [ 38 ]. However, when a strict protocol is followed, this complication is rare.…”