Department of Critical Care Medicine, Hebei General Hospital, Shijiazhuang, China.
Int J Artif Organs. 2023 Sep;46(8-9):498-506. doi: 10.1177/03913988231180639. Epub 2023 Jun 27.
Although continuous renal replacement therapy (CRRT) is common, unplanned interruptions often limit its usefulness. Unplanned interruption refers to the forced interruption of blood purification treatment, the failure to complete blood purification treatment goals or the failure to meet blood purification schedule times. This study aimed to evaluate the effect of haematocrit and activated partial thromboplastin time (APTT) on the incidence of unplanned interruptions in critical patients with CRRT.
A systematic review and a meta-analysis were performed by searching the databases of China National Knowledge Infrastructure, Wanfang, VIP, China Biomedical Literature, Cochrane Library, PubMed, Web of Science and Embase from their inception to 31st March 2022 for all studies with a comparator or independent variable relating to the unplanned interruption of CRRT.
Nine studies involving 1165 participants were included. Haematocrit and APTT were independent risk factors for the unplanned interruption of CRRT. The higher the haematocrit level, the greater the risk of unplanned CRRT interruptions (relative risk ratio [RR] = 1.04, 95% confidence interval [CI]: 1.02, 1.07, = 4.27, < 0.001). The prolongation of APPT reduced the risk of unplanned CRRT interruptions (RR = 0.94, 95% CI: 0.92, 0.96, = 6.10, < 0.001).
Haematocrit and APTT are the influencing factors on the incidence of unplanned interruptions in critical patients undergoing CRRT.
连续肾脏替代治疗(CRRT)虽已广泛应用,但计划外中断时常限制其应用。计划外中断是指被迫中断血液净化治疗、无法完成血液净化治疗目标或无法满足血液净化时间表时间。本研究旨在评估血细胞比容和活化部分凝血活酶时间(APTT)对 CRRT 危重症患者计划外中断发生率的影响。
通过检索中国知网、万方、维普、中国生物医学文献、 Cochrane Library、PubMed、Web of Science 和 Embase 数据库,从建库至 2022 年 3 月 31 日,全面检索所有比较或独立变量与 CRRT 计划外中断相关的研究,进行系统评价和荟萃分析。
纳入 9 项研究共 1165 名参与者。血细胞比容和 APTT 是 CRRT 计划外中断的独立危险因素。血细胞比容水平越高,CRRT 计划外中断的风险越大(相对风险比 [RR] = 1.04,95%置信区间 [CI]:1.02,1.07,= 4.27,< 0.001)。APTT 延长可降低 CRRT 计划外中断的风险(RR = 0.94,95% CI:0.92,0.96,= 6.10,< 0.001)。
血细胞比容和 APTT 是 CRRT 危重症患者计划外中断发生率的影响因素。