Preliminary application of the Sharesource connect data collection and analysis system in the management of continuous renal replacement therapy in the intensive care unit.
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引用次数: 0
Abstract
Background: This study investigated the application of software-based data monitoring for quality control (QC) in continuous renal replacement therapy (CRRT) management.
Methods: This single-center pre-post intervention study, conducted in three ICUs of a tertiary hospital in Shanghai, compared outcomes before (Jan-Dec 2023) and after (Jan-Dec 2024) implementing the Sharesource Connect system. Data from 9 Prismaflex CRRT machines were collected retrospectively during 2023 and prospectively on a monthly basis during 2024. Alongside the software, a comprehensive quality improvement program: (1) multidisciplinary team collaboration; (2) data-driven QC; and (3) structured training. Primary outcomes-filter lifespan, downtime percentage, delivered/prescribed dose ratio, ultrafiltration volume, and vascular access alarms-were compared.
Results: A total of 798 filters from 514 patients (2023) and 717 filters from 492 patients (2024) were analyzed. Key quality metrics improved significantly following implementation (2024 vs. 2023): Filter lifespan increased significantly from 20.08 ± 4.12 h to 24.08 ± 4.27 h (P = 0.043), Kaplan-Meier analysis demonstrated improved filter survival (Log-Rank p < 0.001). Cumulative survival increased from 2023 to 2024 at key time points: 12 h (69.1%-87.2%, + 18.1%), 24 h (30.9%-34.6%, + 3.7%), and 36 h (5.6%-13.6%, + 8.0%), with consistent improvements observed. Downtime percentage decreased from 39 to 28% (P = 0.015), reducing non-effective treatment time by 11 percentage points. The delivered/prescribed dose ratio increased from 82 to 86% (P = 0.046). The mean delivered dose was 35.67 ± 4.01 mL/kg/h (prescribed: 41.33 ± 4.5 mL/kg/h). Ultrafiltration volume remained stable (3.13 ± 0.37 vs. 3.52 ± 0.44 L/treatment day, P = 0.058). There was no significant difference in vascular access alarms (3.39 ± 1.44 vs. 2.93 ± 0.73 events/day, P = 0.392).
Conclusion: The Sharesource Connect system could be used for the monitoring, collection, and analysis of CRRT data to assist in the QC management related to CRRT, so as to provide a software basis for further multi-center studies or random control trials on the intelligent management of critical patients undergoing CRRT.
期刊介绍：
"Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction.
Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.
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