Variables Associated with Circuit Life Span in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy: A Prospective Observational Study
Variables Associated with Circuit Life Span in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy: A Prospective Observational Study
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DOI：
10.1097/mat.0b013e31823fdf20
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发表时间：
2012-01-01
期刊：
影响因子：
4.2
通讯作者：
Lu, Baolong
中科院分区：
文献类型：
--
作者：
Zhang, Zhongheng;Ni, Hongying;Lu, Baolong
进行持续肾替代治疗（CRRT）的最大问题之一是肾循环的过早凝固。本研究的目的是对神经回路功能进行前瞻性监测，并分析可能影响神经回路寿命的患者相关变量。对2010年8月至2011年8月在某三级医院重症监护室接受连续静脉-静脉血液滤过（CVVH）联合全身肝素抗凝治疗的危重患者进行前瞻性研究。收集体温、血pH值、离子钙水平、活化部分凝血活素时间（aPTT）、凝血酶原时间（PT）、血小板计数和肝素剂量等变量，分析它们与电路寿命的关系。54例接受CVVH治疗的患者被纳入，255个过滤器。滤芯寿命为29.7±13.4小时（平均±标准差[SD]）。存活时间较长的电路表现为体温较低（37.80 +/- 1.14 vs. 36.36 +/- 1.09, p < 0.05），血清离子钙水平较低（0.80 vs. 1.29, p < 0.05），酸性更强（7.233 vs. 7.377, p < 0.05）。Cox回归分析显示，pH值和离子钙水平与电路寿命显著相关。红细胞压积、白蛋白水平、血小板计数、aPTT、PT或肝素剂量等其他变量与回路寿命无显著相关性。ASAIO Journal 2012；58:46-50。
One of the greatest problems in performing continuous renal replacement therapy (CRRT) is premature coagulation of the circuit. The aim of the current study was to monitor the circuit function prospectively and analyze patient-related variables that may affect circuit life. Critically ill patients admitted to the intensive care unit of a tertiary hospital between August 2010 and August 2011 receiving continuous veno-venous hemofiltration (CVVH) with systemic heparin anticoagulation were prospectively studied. Variables including body temperature, blood pH value, ionized calcium level, activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, and heparin dose were collected and analyzed for their association with circuit life span. Fifty-four patients treated by CVVH were included, with 255 filters. The filter life was 29.7 +/- 13.4 hours (mean +/- standard deviation [SD]). Circuits with longer survival time appeared to have lower body temperature (37.80 +/- 1.14 vs. 36.36 +/- 1.09; p < 0.05), lower levels of serum ionized calcium (0.80 vs. 1.29; p < 0.05), and to be more acidic (7.233 vs. 7.377; p < 0.05). Cox regression showed that pH value and ionized calcium levels were significantly associated with circuit life. Other variables of hematocrit, albumin levels, platelet count, aPTT, PT, or dose of heparin were not significantly associated with circuit life. ASAIO Journal 2012; 58:46-50.