Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma Patients

Introduction. Acute kidney injury (AKI) necessitating continuous renal replacement therapy (CRRT) is a severe complication in trauma patients (TP). We wanted to assess daily duration of CRRT and its impact on uremic control in TP. Material and Methods. We retrospectively reviewed adult TP, with or w...

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Main Authors: Sigrid Beitland, Kjetil Sunde, Harald Moen, Ingrid Os
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2012/869237
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author Sigrid Beitland
Kjetil Sunde
Harald Moen
Ingrid Os
author_facet Sigrid Beitland
Kjetil Sunde
Harald Moen
Ingrid Os
author_sort Sigrid Beitland
collection DOAJ
description Introduction. Acute kidney injury (AKI) necessitating continuous renal replacement therapy (CRRT) is a severe complication in trauma patients (TP). We wanted to assess daily duration of CRRT and its impact on uremic control in TP. Material and Methods. We retrospectively reviewed adult TP, with or without rhabdomyolysis, with AKI undergoing CRRT. Data on daily CRRT duration and causes for temporary stops were collected from the first five CRRT days. Uremic control was assessed by daily changes in serum urea (Δurea) and creatinine (Δcreatinine) concentrations. Results. Thirty-six TP were included with a total of 150 CRRT days, 17 (43%) with rhabdomyolysis. The median (interquartile range (IQR)) time per day with CRRT was 19 (15–21) hours. There was a significant correlation between daily CRRT duration and Δurea (r=0.60, P≤0.001) and Δcreatinine (r=0.43; P=0.012). CRRT pauses were caused by filter clotting (54%), therapeutic interventions (25%), catheter related problems (10%), filter timeout (6%), and diagnostic procedures (6%). Rhabdomyolysis did not affect the CRRT data. Conclusions. TP undergoing CRRT had short daily CRRT duration causing reduced uremic control. Clinicians should modify their daily clinical practice to improve technical skills and achieve sufficient dialysis dose.
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spelling doaj-art-d621aece74184c3cb0841f4e3cb60ba32025-08-20T03:23:39ZengWileyCritical Care Research and Practice2090-13052090-13132012-01-01201210.1155/2012/869237869237Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma PatientsSigrid Beitland0Kjetil Sunde1Harald Moen2Ingrid Os3Division of Emergencies and Critical Care, Department of Anesthesiology, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, NorwayDivision of Emergencies and Critical Care, Department of Anesthesiology, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, NorwayDepartment of Informatics, Oslo Hospital Services, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, NorwayInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, NorwayIntroduction. Acute kidney injury (AKI) necessitating continuous renal replacement therapy (CRRT) is a severe complication in trauma patients (TP). We wanted to assess daily duration of CRRT and its impact on uremic control in TP. Material and Methods. We retrospectively reviewed adult TP, with or without rhabdomyolysis, with AKI undergoing CRRT. Data on daily CRRT duration and causes for temporary stops were collected from the first five CRRT days. Uremic control was assessed by daily changes in serum urea (Δurea) and creatinine (Δcreatinine) concentrations. Results. Thirty-six TP were included with a total of 150 CRRT days, 17 (43%) with rhabdomyolysis. The median (interquartile range (IQR)) time per day with CRRT was 19 (15–21) hours. There was a significant correlation between daily CRRT duration and Δurea (r=0.60, P≤0.001) and Δcreatinine (r=0.43; P=0.012). CRRT pauses were caused by filter clotting (54%), therapeutic interventions (25%), catheter related problems (10%), filter timeout (6%), and diagnostic procedures (6%). Rhabdomyolysis did not affect the CRRT data. Conclusions. TP undergoing CRRT had short daily CRRT duration causing reduced uremic control. Clinicians should modify their daily clinical practice to improve technical skills and achieve sufficient dialysis dose.http://dx.doi.org/10.1155/2012/869237
spellingShingle Sigrid Beitland
Kjetil Sunde
Harald Moen
Ingrid Os
Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma Patients
Critical Care Research and Practice
title Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma Patients
title_full Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma Patients
title_fullStr Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma Patients
title_full_unstemmed Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma Patients
title_short Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma Patients
title_sort variability in uremic control during continuous venovenous hemodiafiltration in trauma patients
url http://dx.doi.org/10.1155/2012/869237
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AT haraldmoen variabilityinuremiccontrolduringcontinuousvenovenoushemodiafiltrationintraumapatients
AT ingridos variabilityinuremiccontrolduringcontinuousvenovenoushemodiafiltrationintraumapatients