Impact d’un programme d’amélioration de la stabilité de l’épuration extrarénale continue

Annales Francaises D Anesthesie Et De Reanimation Pub Date : 2014-12-01 DOI:10.1016/j.annfar.2014.10.008

M. Page, T. Rimmelé, J. Prothet, F. Christin, J. Crozon, C.-E. Ber

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引用次数: 8

Abstract

Objectives

During continuous renal replacement therapy (CRRT), circuit clotting increases nursing workload, cost of the therapy and blood loss. The aim of this study was to assess the impact of a program designed to improve CRRT stability on unexpected circuit clotting.

Study design

Retrospective and observational study.

Patients and methods

In January 2011, several changes have been adopted regarding CRRT management. Regional citrate anticoagulation, continuous hemodialysis using super high-flux membranes and a specific training for intensive care unit nurses were implemented. CRRT sessions before (year 2009 and 2010, “Before group”) and after (year 2011 and 2012, “After group”) were analyzed. The primary endpoint was the incidence of unexpected CRRT session end.

Results

During the study period, 401 sessions performed in 152 patients were analyzed. Sixty-three unexpected session's end (40%) occurred before and 43 (17%) after the implementation of the program (P < 0.0001). Median filter life time was 33 (13–48) hours before and 55 (27–67) hours after (P < 0.0001).

Conclusion

Our program designed to improve CRRT stability reduced filter losses by reducing unexpected circuit clotting.

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持续改善水净化稳定性方案的影响

目的:在持续肾替代治疗(CRRT)中，循环凝血增加了护理工作量、治疗费用和出血量。本研究的目的是评估一个旨在改善CRRT稳定性的程序对意外回路凝血的影响。研究设计回顾性观察性研究。患者和方法2011年1月，对CRRT的管理进行了一些修改。实施了区域柠檬酸抗凝、使用超高通量膜的持续血液透析和对重症监护病房护士的专门培训。分析了2009年和2010年之前(“前组”)和2011年和2012年之后(“后组”)的CRRT会话。主要终点是CRRT会话意外结束的发生率。结果在研究期间，对152例患者的401次治疗进行了分析。63次意外结束(40%)发生在计划实施之前，43次(17%)发生在计划实施之后(P <0.0001)。滤芯使用前的中位寿命为33(13-48)小时，使用后的中位寿命为55(27-67)小时(P <0.0001)。结论我们的方案通过减少意外的电路凝血来提高CRRT的稳定性，降低滤波器损耗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annales Francaises D Anesthesie Et De Reanimation 医学-麻醉学

自引率

0.00%

发文量

审稿时长

3-8 weeks