Centro de Tratamento Intensivo, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.
Rev Bras Ter Intensiva. 2021 Jan-Mar;33(1):111-118. doi: 10.5935/0103-507X.20210012.
To evaluate the incidence of hypothermia in patients undergoing continuous renal replacement therapy in the intensive care unit. As secondary objectives, we determined associated factors and compared the occurrence of hypothermia between two modalities of continuous renal replacement therapy.
A prospective cohort study was conducted with adult patients who were admitted to a clinical-surgical intensive care unit and underwent continuous renal replacement therapy in a high-complexity public university hospital in southern Brazil from April 2017 to July 2018. Hypothermia was defined as a body temperature ≤ 35ºC. The patients included in the study were followed for the first 48 hours of continuous renal replacement therapy. The researchers collected data from medical records and continuous renal replacement therapy records.
A total of 186 patients were equally distributed between two types of continuous renal replacement therapy: hemodialysis and hemodiafiltration. The incidence of hypothermia was 52.7% and was higher in patients admitted for shock (relative risk of 2.11; 95%CI 1.21 - 3.69; p = 0.009) and in those who underwent hemodiafiltration with heating in the return line (relative risk of 1.50; 95%CI 1.13 - 1.99; p = 0.005).
Hypothermia in critically ill patients with continuous renal replacement therapy is frequent, and the intensive care team should be attentive, especially when there are associated risk factors.
评估重症监护病房行连续性肾脏替代治疗患者发生低体温的情况。作为次要目标,我们确定了相关因素,并比较了两种连续性肾脏替代治疗方式中低体温的发生情况。
这是一项前瞻性队列研究,纳入了 2017 年 4 月至 2018 年 7 月在巴西南部一家高复杂性公立大学医院临床外科重症监护病房接受连续性肾脏替代治疗的成年患者。低体温定义为体温≤35°C。研究对象在接受连续性肾脏替代治疗的最初 48 小时内进行随访。研究人员从病历和连续性肾脏替代治疗记录中收集数据。
共有 186 例患者被平均分配到两种连续性肾脏替代治疗方式:血液透析和血液透析滤过。低体温的发生率为 52.7%,在因休克而入院的患者(相对风险 2.11;95%CI 1.21-3.69;p=0.009)和接受回输加热的血液透析滤过患者中(相对风险 1.50;95%CI 1.13-1.99;p=0.005)中更高。
连续性肾脏替代治疗的危重症患者中低体温很常见,重症监护团队应保持警惕,尤其是存在相关危险因素时。