Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis

Objective To systematically review the risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients.Methods A combination of subject words + free words was used to search the relevant literature published in CNKI, Wanfang, VIP, CBM, PubMed, EMbase, Web of Science, C...

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Main Authors: Zhi Zeng, Yuqi Shen, Li Wan, Xiuru Yang, Zhenghua Liang, Mei He
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2024.2387431
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author Zhi Zeng
Yuqi Shen
Li Wan
Xiuru Yang
Zhenghua Liang
Mei He
author_facet Zhi Zeng
Yuqi Shen
Li Wan
Xiuru Yang
Zhenghua Liang
Mei He
author_sort Zhi Zeng
collection DOAJ
description Objective To systematically review the risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients.Methods A combination of subject words + free words was used to search the relevant literature published in CNKI, Wanfang, VIP, CBM, PubMed, EMbase, Web of Science, Cochrane Library, Mediline and other databases. The search period was from the establishment of the databases to June 25, 2024. Revman 5.4 software and Stata15.0 software was used to meta-analyze the risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients.Results A total of 23 studies were included in this meta-analysis, describing 15 variables, 3793 patients, and using 7197 filters. Meta-analysis results showed that risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients were as follows: Low mean arterial pressure [OR = 1.02, 95%CI (1.00, 1.03), p < 0.05], hypothermia [OR = 3.40, 95%CI (1.78, 6.47), p < 0.05], age (≥60 years) [OR = 4.45, 95%CI (3.18, 6.22), p < 0.05], comorbid underlying disease [OR = 3.63, 95%CI (2.70, 4.88), p < 0.05], agitation [OR = 4.97, 95%CI (3.20, 7.74), p < 0.05], no anticoagulant use [OR = 1.65, 95%CI (1.25, 2.17), p < 0.05], short activated partial prothrombin time [OR = 1.23, 95%CI (1.13, 1.34), p < 0.05], hyper-hematocrit [OR = 1.73, 95%CI (1.13, 2.66), p = 0.01], low ionized calcium concentration [OR = 1.48, 95% CI (1.08, 2.02), p = 0.01], CRRT that was treated at a high dose [OR = 1.42, 95%CI (1.14, 1.76), p < 0.05], mechanical ventilation [OR = 4.25, 95%CI (2.67, 6.77), p < 0.05], and lack of dedicated care [OR = 5.08, 95%CI (2.51, 10.28), p < 0.05]. However, it is unclear whether platelet count, prothrombin activity, and blood flow velocity are risk factors for unplanned weaning during CRRT in ICU patients, and more studies are needed for further validation.Conclusion Available evidence suggests that a variety of factors contribute to unplanned weaning of CRRT in ICU patients. Early detection of these risk factors is essential for healthcare professionals to develop preventive and curative strategies.Registration This study is registered on the PROSERO website under registration number CRD42024543554.
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spelling doaj-art-d09327aecec34d56b7e1ec8e268a2e412025-08-20T03:12:51ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2387431Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysisZhi Zeng0Yuqi Shen1Li Wan2Xiuru Yang3Zhenghua Liang4Mei He5Intensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaIntensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaIntensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaIntensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaIntensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaIntensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaObjective To systematically review the risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients.Methods A combination of subject words + free words was used to search the relevant literature published in CNKI, Wanfang, VIP, CBM, PubMed, EMbase, Web of Science, Cochrane Library, Mediline and other databases. The search period was from the establishment of the databases to June 25, 2024. Revman 5.4 software and Stata15.0 software was used to meta-analyze the risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients.Results A total of 23 studies were included in this meta-analysis, describing 15 variables, 3793 patients, and using 7197 filters. Meta-analysis results showed that risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients were as follows: Low mean arterial pressure [OR = 1.02, 95%CI (1.00, 1.03), p < 0.05], hypothermia [OR = 3.40, 95%CI (1.78, 6.47), p < 0.05], age (≥60 years) [OR = 4.45, 95%CI (3.18, 6.22), p < 0.05], comorbid underlying disease [OR = 3.63, 95%CI (2.70, 4.88), p < 0.05], agitation [OR = 4.97, 95%CI (3.20, 7.74), p < 0.05], no anticoagulant use [OR = 1.65, 95%CI (1.25, 2.17), p < 0.05], short activated partial prothrombin time [OR = 1.23, 95%CI (1.13, 1.34), p < 0.05], hyper-hematocrit [OR = 1.73, 95%CI (1.13, 2.66), p = 0.01], low ionized calcium concentration [OR = 1.48, 95% CI (1.08, 2.02), p = 0.01], CRRT that was treated at a high dose [OR = 1.42, 95%CI (1.14, 1.76), p < 0.05], mechanical ventilation [OR = 4.25, 95%CI (2.67, 6.77), p < 0.05], and lack of dedicated care [OR = 5.08, 95%CI (2.51, 10.28), p < 0.05]. However, it is unclear whether platelet count, prothrombin activity, and blood flow velocity are risk factors for unplanned weaning during CRRT in ICU patients, and more studies are needed for further validation.Conclusion Available evidence suggests that a variety of factors contribute to unplanned weaning of CRRT in ICU patients. Early detection of these risk factors is essential for healthcare professionals to develop preventive and curative strategies.Registration This study is registered on the PROSERO website under registration number CRD42024543554.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2387431Intensive care unitcontinuous renal replacement therapyunplanned weaningrisk factorsmeta-analysis
spellingShingle Zhi Zeng
Yuqi Shen
Li Wan
Xiuru Yang
Zhenghua Liang
Mei He
Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis
Renal Failure
Intensive care unit
continuous renal replacement therapy
unplanned weaning
risk factors
meta-analysis
title Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis
title_full Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis
title_fullStr Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis
title_full_unstemmed Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis
title_short Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis
title_sort risk factors for unplanned weaning of continuous renal replacement therapy in icu patients a meta analysis
topic Intensive care unit
continuous renal replacement therapy
unplanned weaning
risk factors
meta-analysis
url https://www.tandfonline.com/doi/10.1080/0886022X.2024.2387431
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