Filter Size Not the Anticoagulation Method is the Decisive Factor in Continuous Renal Replacement Therapy Circuit Survival

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 ci...

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Bibliographic Details
Published in:Kidney & blood pressure research 2017-01, Vol.42 (2), p.327-337
Main Authors: Miklaszewska, Monika, Korohoda, Przemysław, Zachwieja, Katarzyna, Kobylarz, Krzysztof, Stefanidis, Constantinos J., Sobczak, Alina, Drożdż, Dorota
Format: Article
Language:English
Subjects:
Anticoagulants
Anticoagulants - therapeutic use
Anticoagulation
Child
Circuit
Circuits
Citric Acid
Clotting
CRRT
Female
Filter
Filters
Hemodialysis
Heparin
Hospitals
Humans
Intensive care
Intensive care units
Kidneys
Male
Metabolism
Micropore Filters - standards
Original Paper
Patients
Pediatrics
Peritoneal Dialysis, Continuous Ambulatory
PICU
Porosity
Renal replacement therapy
Renal Replacement Therapy - instrumentation
Renal Replacement Therapy - methods
Retrospective Studies
Survival
Therapy
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Summary: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.
ISSN:1420-4096
1423-0143
DOI:10.1159/000477609