Monika Miklaszewska1, Przemysław Korohoda2, Katarzyna Zachwieja1, Krzysztof Kobylarz3, Constantinos J Stefanidis4, Alina Sobczak5, Dorota Drożdż1. 1. Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Kraków, Poland. 2. AGH University of Science and Technology, Faculty of Computer Science, Electronics and Telecommunications, Department of Electronics, Kraków, Poland. 3. Department of Anesthesiology and Intensive Care, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland. 4. Department of Pediatric Nephrology "A. and P. Kyriakou" Children's Hospital, Athens, Greece. 5. Department of Pediatrics, Faculty of Medicine, Jagiellonian University, Kraków, Poland.
Abstract
BACKGROUND/AIM: As continuous renal replacement therapy (CRRT) has emerged as a standard therapy in pediatric intensive care units (PICU), many related issues that may have an impact on circuit survival have gained in importance. Objective of the study was an evaluation of factors associated with circuit survival, including anticoagulation (ACG). METHODS: Retrospective study that included 40 patients, who in total received 7636 hours of CRRT during 150 sessions (84 filters, 4260 hours with heparin anticoagulation (Hep-ACG); 66 filters, 3376 hours with regional citrate anticoagulation (RCA)). RESULTS: The Kaplan-Meier analysis of the total circuit survival time depending on the type of ACG did not demonstrate a significant difference between Hep-ACG and RCA. The percentage of clotted filters was significantly higher in case of smaller filters (HF20: 58.8%; ST60: 29.5%; ST100: 15.8%), and their lifetime was significantly lower regardless of ACG (the mean and median lifetime for HF20: 38.7/27.0 h; for ST60: 54.1/72.0 h., for ST100: 62.1/72.0 h, respectively). CONCLUSIONS: Irrespectively of filter size, filter clotting occurs within the first 24 hours after the initiation of CRRT. Most commonly, clotting affects small filters, and their lifetime is significantly shorter as compared to larger filters regardless of the type of the ACG.
BACKGROUND/AIM: As continuous renal replacement therapy (CRRT) has emerged as a standard therapy in pediatric intensive care units (PICU), many related issues that may have an impact on circuit survival have gained in importance. Objective of the study was an evaluation of factors associated with circuit survival, including anticoagulation (ACG). METHODS: Retrospective study that included 40 patients, who in total received 7636 hours of CRRT during 150 sessions (84 filters, 4260 hours with heparin anticoagulation (Hep-ACG); 66 filters, 3376 hours with regional citrate anticoagulation (RCA)). RESULTS: The Kaplan-Meier analysis of the total circuit survival time depending on the type of ACG did not demonstrate a significant difference between Hep-ACG and RCA. The percentage of clotted filters was significantly higher in case of smaller filters (HF20: 58.8%; ST60: 29.5%; ST100: 15.8%), and their lifetime was significantly lower regardless of ACG (the mean and median lifetime for HF20: 38.7/27.0 h; for ST60: 54.1/72.0 h., for ST100: 62.1/72.0 h, respectively). CONCLUSIONS: Irrespectively of filter size, filter clotting occurs within the first 24 hours after the initiation of CRRT. Most commonly, clotting affects small filters, and their lifetime is significantly shorter as compared to larger filters regardless of the type of the ACG.
Authors: Emanuele Buccione; Stefano Bambi; Laura Rasero; Lorenzo Tofani; Tessa Piazzini; Carlo Della Pelle; Khadija El Aoufy; Zaccaria Ricci; Stefano Romagnoli; Gianluca Villa Journal: J Clin Med Date: 2022-05-31 Impact factor: 4.964
Authors: Adam Locke; Margaret A Bushey; Cynthia LaCroix; Patience Deardoff; Macaulay Amechi Chukwukadibia Onuigbo Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-11-06