Department of Surgery, Emory University School of Medicine, Atlanta, GA; Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA.
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.
J Crit Care. 2014 Apr;29(2):272-7. doi: 10.1016/j.jcrc.2013.11.012. Epub 2013 Nov 25.
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.
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.
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).
There was no demonstrable difference in circuit patency as defined by the rate of filter exchanges per day of CRRT therapy.
连续肾脏替代疗法（CRRT）是危重病患者护理的重要工具。然而，特定的 CRRT 机器类型对 CRRT 成功实施的影响尚不清楚。本研究旨在评估 ICU 床边护士实施 CRRT 的效果，同时比较 2 种经美国食品和药物管理局批准的 CRRT 设备的回路通畅率和回路更换率。本文介绍了比较 2 种不同 CRRT 机器回路更换率的数据。
选择一组 ICU 护士进行 CRRT 操作的扩展培训，并授权他们提供 CRRT 的各个方面。然后，ICU 护士在 2 种经美国食品和药物管理局批准的 CRRT 设备上提供 CRRT 的各个方面，为期 6 个月。每个设备在指定的 ICU 中单独使用 2 周的运行期，然后进行 3 个月的数据收集期。该研究的主要终点是每个 CRRT 事件中平均每天的过滤器更换次数的差异。
共有 45 名接受了 64 次单独 CRRT 治疗的患者被纳入研究。排除了 4 次 CRRT 事件（详见正文）。28 次 CRRT 事件发生在 NxStage System One 机器臂（NxStage Medical，劳伦斯，马萨诸塞州），32 次事件发生在 Gambro Prismaflex 机器臂（Gambro Renal Products，博尔德，科罗拉多州）。NxStage System One 机器每天的平均（SD）过滤器更换次数为 0.443（0.60），Gambro Prismaflex 机器为 0.553（0.65）（P =.09）。
在 CRRT 治疗期间每天的过滤器更换次数定义的回路通畅率方面，没有表现出明显的差异。
