Perioperative and Intensive Care, Skåne University Hospital, Lund, Sweden.
Acta Anaesthesiol Scand. 2020 Sep;64(8):1162-1166. doi: 10.1111/aas.13616. Epub 2020 Jun 1.
One of the most common adverse events during continuous renal replacement therapy (CRRT) is hypothermia, reported to occur in over 4/10 cases. In turn, hypothermia is known to be associated with higher mortality rates among patients treated in intensive care units (ICU). The present study examined if a novel warming device in the current generation of CRRT systems could lower incidence of hypothermia compared to previous generation technology.
We included ICU patients >18 years, at Skåne University Hospital, Lund from November 2006 to August 2019 and treated with CRRT. Temperature measurements were recorded from the CRRT systems and from the patients hourly.
In total, 310 patients treated with the older system vs 32 patients treated using the newer CRRT system were included. We found that historic Prismaflex patients spent 11.43% of their time in hypothermia, as compared to the novel Prismax CRRT system, where 10.06% of patient hours were below 36.0°C (Chi-Square P = .0063). The novel blood warmer is associated with less heat loss compared to the older warmer: mean patient temperature was 37°C vs 36.5°C for these two groups and mean set return temperature was 37.9°C vs 40.9°C (both P < .001).
The current generation CRRT system and blood warmer significantly decreases the risk of hypothermia among critically ill patients treated with continuous renal replacement therapy as compared to historic controls. Achieving target temperature is easier with the new system.
在连续肾脏替代疗法（CRRT）过程中，最常见的不良事件之一是低体温，据报道，超过 4/10 的病例会发生这种情况。反过来，低体温与重症监护病房（ICU）中患者的死亡率升高有关。本研究旨在检查当前一代 CRRT 系统中的新型加热设备是否能降低低体温的发生率，与前一代技术相比。
我们纳入了 2006 年 11 月至 2019 年 8 月在瑞典隆德斯科讷大学医院接受 CRRT 治疗的>18 岁 ICU 患者。从 CRRT 系统和患者每小时记录温度测量值。
共纳入 310 例使用旧系统治疗的患者和 32 例使用新型 CRRT 系统治疗的患者。我们发现，与新型 Prismax CRRT 系统相比，历史悠久的 Prismaflex 患者有 11.43%的时间处于低体温状态，而新型 Prismax CRRT 系统中，有 10.06%的患者小时数低于 36.0°C（卡方 P=0.0063）。新型血液加温器与旧型加温器相比，热量损失更少：两组患者的平均体温分别为 37°C 和 36.5°C，平均设定回温分别为 37.9°C 和 40.9°C（均 P<0.001）。
与历史对照相比，当前一代 CRRT 系统和血液加温器显著降低了接受连续肾脏替代治疗的危重症患者发生低体温的风险。新系统更容易达到目标温度。
