BACKGROUND AND AIMS: In vasopressor-dependent patients, we evaluated the impact of a slow blood flow protocol on hypotension when starting continuous renal replacement therapy (CRRT). METHODS: Retrospective observational study in tertiary ICU of a slow blood flow protocol at the start of CRRT circuits. RESULTS: 205 circuits in 52 patients were studied. No significant changes in mean arterial pressure (MAP) and norepinephrine dose were found. Only 16 circuit starts in 13 patients were associated with a decrease in MAP >20%. In 23 filters and 11 patients, norepinephrine dose was >50 μg/min at baseline and also did not change significantly. There were no cardiac arrests or ventricular arrhythmias and CRRT was not discontinued because of hypotension. CONCLUSIONS: Implementation of a CRRT slow blood flow protocol in vasopressor-dependent patients enabled the initiation of CRRT circuits with limited hemodynamic consequences and no cardiac arrest or ventricular arrhythmia.
BACKGROUND AND AIMS: In vasopressor-dependent patients, we evaluated the impact of a slow blood flow protocol on hypotension when starting continuous renal replacement therapy (CRRT). METHODS: Retrospective observational study in tertiary ICU of a slow blood flow protocol at the start of CRRT circuits. RESULTS: 205 circuits in 52 patients were studied. No significant changes in mean arterial pressure (MAP) and norepinephrine dose were found. Only 16 circuit starts in 13 patients were associated with a decrease in MAP >20%. In 23 filters and 11 patients, norepinephrine dose was >50 μg/min at baseline and also did not change significantly. There were no cardiac arrests or ventricular arrhythmias and CRRT was not discontinued because of hypotension. CONCLUSIONS: Implementation of a CRRT slow blood flow protocol in vasopressor-dependent patients enabled the initiation of CRRT circuits with limited hemodynamic consequences and no cardiac arrest or ventricular arrhythmia.
Authors: Adrianna Douvris; Gurpreet Malhi; Swapnil Hiremath; Lauralyn McIntyre; Samuel A Silver; Sean M Bagshaw; Ron Wald; Claudio Ronco; Lindsey Sikora; Catherine Weber; Edward G Clark Journal: Crit Care Date: 2018-02-22 Impact factor: 9.097
Authors: Sarah Fernández; Maria José Santiago; Rafael González; Javier Urbano; Jorge López; Maria José Solana; Amelia Sánchez; Jimena Del Castillo; Jesús López-Herce Journal: Pediatr Nephrol Date: 2018-08-15 Impact factor: 3.714