Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study

BackgroundDuring continuous renal replacement therapy (CRRT), circuit coagulation is an important event that can result in suboptimal outcomes. Nurses must remain alert throughout the treatment and observe machine pressures. Transmembrane pressure (TMP) is commonly used for monitoring but it is some...

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Autores: Mateos-Dávila A., Roig, AJB, Rodriguez, JAS, Guix-Comellas E.M.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p16288
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16288
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85161410169&doi=10.1111%2fnicc.12933&partnerID=40&md5=420eed413c621872cbbf0c442a79cfe8
Access Level:acceso abierto
Palabra clave:acute renal failure (ARF)
circuit coagulation
circuit lifespan
continuous renal replacement therapy (CRRT)
prefilter
filter pressure (FP)
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spelling Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational studyMateos-Dávila A.Roig, AJBRodriguez, JASGuix-Comellas E.M.acute renal failure (ARF)circuit coagulationcircuit lifespancontinuous renal replacement therapy (CRRT)prefilterfilter pressure (FP)BackgroundDuring continuous renal replacement therapy (CRRT), circuit coagulation is an important event that can result in suboptimal outcomes. Nurses must remain alert throughout the treatment and observe machine pressures. Transmembrane pressure (TMP) is commonly used for monitoring but it is sometimes too late to return blood to the patient.AimTo compare the capacity of prefilter pressure (FP) versus TMP to predict the risk of circuit coagulation in adult patients with acute renal failure on CRRT.Study DesignAn observational, longitudinal, prospective study. This study was carried out in a tertiary referral hospital over 2 years. Data collected included the following variables: TMP, filter or FP, effluent pressure, venous and arterial pressure, filtration fraction, and ultrafiltration constant of each circuit. Means and their trends over time were collected, for both diffusive and convective therapy and for two membrane types.ResultsA total of 151 circuits (24 polysulfone and 127 acrylonitrile) were analysed, from 71 patients (n = 22 [34%] women; mean age, 66.5 [36-84] years). Of the total treatments, 80 were diffusive, and the rest were convective or mixed. In the diffusive circuits, a progressive rise in FP was observed without an increase in TMP and with an increasing trend in effluent pressure. Circuit lifespan was between 2 and 90 h. In 11% (n = 17) of the cases, the blood could not be returned to the patient.ConclusionThese findings allowed the creation of graphs that indicate the appropriate point to return blood to the patient. FP was a major determinant in this decision; in most cases, TMP was not a reliable parameter. Our findings are applicable to convective, diffusive, and mixed treatments as well as both types of membranes used in this acute setting.Relevance to Clinical PracticeThis study provides two clear reference graphs showing risk scales for the assessment of circuit pressures in CRRT. The graphs proposed here can be used to evaluate any machine on the market and the two types of membranes used in this acute setting. Both convective and diffusive circuits can be assessed, allowing safer evaluation in patients who change treatment.WILEY2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16288https://www.scopus.com/inward/record.uri?eid=2-s2.0-85161410169&doi=10.1111%2fnicc.12933&partnerID=40&md5=420eed413c621872cbbf0c442a79cfe8Nursing in Critical CareISSN: 13621017ISSNe: 14785153reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p162882026-06-14T12:41:47Z
dc.title.none.fl_str_mv Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study
title Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study
spellingShingle Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study
Mateos-Dávila A.
acute renal failure (ARF)
circuit coagulation
circuit lifespan
continuous renal replacement therapy (CRRT)
prefilter
filter pressure (FP)
title_short Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study
title_full Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study
title_fullStr Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study
title_full_unstemmed Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study
title_sort Change in prefilter pressure as a key determinant in the decision to return blood in continuous renal replacement therapy: An observational study
dc.creator.none.fl_str_mv Mateos-Dávila A.
Roig, AJB
Rodriguez, JAS
Guix-Comellas E.M.
author Mateos-Dávila A.
author_facet Mateos-Dávila A.
Roig, AJB
Rodriguez, JAS
Guix-Comellas E.M.
author_role author
author2 Roig, AJB
Rodriguez, JAS
Guix-Comellas E.M.
author2_role author
author
author
dc.subject.none.fl_str_mv acute renal failure (ARF)
circuit coagulation
circuit lifespan
continuous renal replacement therapy (CRRT)
prefilter
filter pressure (FP)
topic acute renal failure (ARF)
circuit coagulation
circuit lifespan
continuous renal replacement therapy (CRRT)
prefilter
filter pressure (FP)
description BackgroundDuring continuous renal replacement therapy (CRRT), circuit coagulation is an important event that can result in suboptimal outcomes. Nurses must remain alert throughout the treatment and observe machine pressures. Transmembrane pressure (TMP) is commonly used for monitoring but it is sometimes too late to return blood to the patient.AimTo compare the capacity of prefilter pressure (FP) versus TMP to predict the risk of circuit coagulation in adult patients with acute renal failure on CRRT.Study DesignAn observational, longitudinal, prospective study. This study was carried out in a tertiary referral hospital over 2 years. Data collected included the following variables: TMP, filter or FP, effluent pressure, venous and arterial pressure, filtration fraction, and ultrafiltration constant of each circuit. Means and their trends over time were collected, for both diffusive and convective therapy and for two membrane types.ResultsA total of 151 circuits (24 polysulfone and 127 acrylonitrile) were analysed, from 71 patients (n = 22 [34%] women; mean age, 66.5 [36-84] years). Of the total treatments, 80 were diffusive, and the rest were convective or mixed. In the diffusive circuits, a progressive rise in FP was observed without an increase in TMP and with an increasing trend in effluent pressure. Circuit lifespan was between 2 and 90 h. In 11% (n = 17) of the cases, the blood could not be returned to the patient.ConclusionThese findings allowed the creation of graphs that indicate the appropriate point to return blood to the patient. FP was a major determinant in this decision; in most cases, TMP was not a reliable parameter. Our findings are applicable to convective, diffusive, and mixed treatments as well as both types of membranes used in this acute setting.Relevance to Clinical PracticeThis study provides two clear reference graphs showing risk scales for the assessment of circuit pressures in CRRT. The graphs proposed here can be used to evaluate any machine on the market and the two types of membranes used in this acute setting. Both convective and diffusive circuits can be assessed, allowing safer evaluation in patients who change treatment.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16288
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85161410169&doi=10.1111%2fnicc.12933&partnerID=40&md5=420eed413c621872cbbf0c442a79cfe8
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16288
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85161410169&doi=10.1111%2fnicc.12933&partnerID=40&md5=420eed413c621872cbbf0c442a79cfe8
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv Nursing in Critical Care
ISSN: 13621017
ISSNe: 14785153
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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