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Critical Care
Published in: Critical Care 4/2008

Open Access 01-08-2008 | Research

Circuit life span in critically ill children on continuous renal replacement treatment: a prospective observational evaluation study

Authors: Jimena del Castillo, Jesús López-Herce, Elena Cidoncha, Javier Urbano, Santiago Mencía, Maria J Santiago, Jose M Bellón

Published in: Critical Care | Issue 4/2008

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Abstract

Introduction

One of the greatest problems with continuous renal replacement therapy (CRRT) is early coagulation of the filters. Few studies have monitored circuit function prospectively. The purpose of this study was to determine the variables associated with circuit life in critically ill children with CRRT.

Methods

A prospective observational study was performed in 122 children treated with CRRT in a pediatric intensive care unit from 1996 to 2006. Patient and filter characteristics were analyzed to determine their influence on circuit life. Data were collected on 540 filters in 122 patients and an analysis was performed of the 365 filters (67.6%) that were changed due to circuit coagulation.

Results

The median circuit life was 31 hours (range 1 to 293 hours). A univariate and multivariate logistic regression study was performed to assess the influence of each one of the factors on circuit life span. No significant differences in filter life were found according to age, weight, diagnoses, pump, site of venous access, blood flow rate, ultrafiltration rate, inotropic drug support, or patient outcome. The mean circuit life span was longer when the heparin dose was greater than 20 U/kg per hour (39 versus 29.1 hours; P = 0.008), with hemodiafiltration compared with hemofiltration (34 versus 22.7 hours; P = 0.001), with filters with surface areas of 0.4 to 0.9 m2 (38.2 versus 26.1 hours; P = 0.01), and with a catheter size of 6.5 French or greater (33.0 versus 25.0 hours; P = 0.04). In the multivariate analysis, hemodiafiltration, heparin dose of greater than 20 U/kg per hour, filter surface area of 0.4 m2 or greater, and initial creatinine of less than 2 mg/dL were associated with a filter life of more than 24 and 48 hours. Total effluent rate of greater than 35 mL/kg per hour was associated only with a filter life of more than 24 hours.

Conclusion

Circuit life span in CRRT in children is short but may be increased by the use of hemodiafiltration, higher heparin doses, and filters with a high surface area.
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Metadata
Title
Circuit life span in critically ill children on continuous renal replacement treatment: a prospective observational evaluation study
Authors
Jimena del Castillo
Jesús López-Herce
Elena Cidoncha
Javier Urbano
Santiago Mencía
Maria J Santiago
Jose M Bellón
Publication date
01-08-2008
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2008
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc6965

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