Seyed Amirhossein Razavi1, Mary D Still2, Sharon J White3, Timothy G Buchman4, Michael J Connor5. 1. Department of Surgery, Emory University School of Medicine, Atlanta, GA; Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA. Electronic address: amir.razavi@emoryhealthcare.org. 2. Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA; Department of Nursing, Emory University Hospital, Emory University School of Medicine, Atlanta, GA. 3. Department of Palliative Care, Piedmont Fayette Hospital, Fayetteville, GA. 4. Department of Surgery, Emory University School of Medicine, Atlanta, GA; Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA. 5. Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
Abstract
BACKGROUND: Continuous renal replacement therapy (CRRT) is an important tool in the care of critically ill patients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit (ICU) bedside nurse delivery model for CRRT while comparing circuit patency and circuit exchange rates in 2 Food and Drug Administration-approved CRRT devices. This article presents the data comparing circuit exchange rates for 2 different CRRT machines. MATERIALS AND METHODS: A group of ICU nurses were selected to undergo expanded training in CRRT operation and empowered to deliver all aspects of CRRT. The ICU nurses then provided all aspects of CRRT on 2 Food and Drug Administration-approved CRRT devices for 6 months. Each device was used exclusively in the designated ICU for a 2-week run-in period followed by 3-month data collection period. The primary end point for the study was the differences in average number of filter exchanges per day during each CRRT event. RESULTS: A total of 45 unique patients who underwent 64 separate CRRT treatment periods were included. Four CRRT events were excluded (see text for details). Twenty-eight CRRT events occurred in the NxStage System One arm (NxStage Medical, Lawrence, Mass) and 32 events in the Gambro Prismaflex arm (Gambro Renal Products, Boulder, Colo). Average (SD) filter exchanges per day was 0.443 (0.60) for the NxStage System One machine and 0.553 (0.65) for Gambro Prismaflex machine (P = .09). CONCLUSIONS: There was no demonstrable difference in circuit patency as defined by the rate of filter exchanges per day of CRRT therapy.
BACKGROUND: Continuous renal replacement therapy (CRRT) is an important tool in the care of critically illpatients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit (ICU) bedside nurse delivery model for CRRT while comparing circuit patency and circuit exchange rates in 2 Food and Drug Administration-approved CRRT devices. This article presents the data comparing circuit exchange rates for 2 different CRRT machines. MATERIALS AND METHODS: A group of ICU nurses were selected to undergo expanded training in CRRT operation and empowered to deliver all aspects of CRRT. The ICU nurses then provided all aspects of CRRT on 2 Food and Drug Administration-approved CRRT devices for 6 months. Each device was used exclusively in the designated ICU for a 2-week run-in period followed by 3-month data collection period. The primary end point for the study was the differences in average number of filter exchanges per day during each CRRT event. RESULTS: A total of 45 unique patients who underwent 64 separate CRRT treatment periods were included. Four CRRT events were excluded (see text for details). Twenty-eight CRRT events occurred in the NxStage System One arm (NxStage Medical, Lawrence, Mass) and 32 events in the Gambro Prismaflex arm (Gambro Renal Products, Boulder, Colo). Average (SD) filter exchanges per day was 0.443 (0.60) for the NxStage System One machine and 0.553 (0.65) for Gambro Prismaflex machine (P = .09). CONCLUSIONS: There was no demonstrable difference in circuit patency as defined by the rate of filter exchanges per day of CRRT therapy.