Tags

Type your tag names separated by a space and hit enter

Use of online blood volume and blood temperature monitoring during haemodialysis in critically ill patients with acute kidney injury: a single-centre randomized controlled trial.
Nephrol Dial Transplant. 2013 Feb; 28(2):430-7.ND

Abstract

BACKGROUND

Little is known about the clinical impact on cardiovascular stability during intermittent haemodialysis (IHD) for acute kidney injury (AKI) of online monitoring devices that control blood volume (BV) and blood temperature in the intensive care unit (ICU) setting. We compared different dialysis treatment modalities with or without these new systems among critically ill patients requiring IHD.

METHODS

In a prospective single-centre three-arm randomized controlled trial, 600 dialysis sessions in 74 consecutive AKI critically ill patients were involved to assess intradialytic hypotension. Standard dialysis therapy with constant ultrafiltration (UF) rate, cool dialysate and high sodium conductivity (Treatment A) was compared to regimens with adjunctive interventions including BV control (Treatment B) and the combination of BV and active blood temperature control (Treatment C). Each dialysis session was randomly assigned to one of the three treatment arms and served as statistical unit.

RESULTS

Five hundred and seventy-two dialysis sessions were analysed (188, 190 and 194 in Treatments A, B and C, respectively). Hypotension occurred in 16.6% treatments, with similar rates among the arms. Haemodynamic parameters and dialysis-related complications did not differ between therapies. Based on generalized estimating equation adjusted to dialysate sodium conductivity, higher Sequential Organ Failure Assessment the day of dialysis session, the need for vasopressors and lower systolic blood pressure at the onset of the session were identified as independent predictors of hypotensive episodes, whereas regimens containing the new online monitors were not.

CONCLUSIONS

These results suggest that both actively controlled body temperature and UF profiled by online monitoring systems have no significant impact on the incidence of intradialytic hypotension in the ICU setting. Further research is needed before the use of these new sophisticated automatic methods can be applied routinely to the ICU setting.

Authors+Show Affiliations

Department of Medical Intensive Care, CHU de Caen, Caen, France. ducheyron-d@chu-caen.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22535635

Citation

du Cheyron, Damien, et al. "Use of Online Blood Volume and Blood Temperature Monitoring During Haemodialysis in Critically Ill Patients With Acute Kidney Injury: a Single-centre Randomized Controlled Trial." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 28, no. 2, 2013, pp. 430-7.
du Cheyron D, Terzi N, Seguin A, et al. Use of online blood volume and blood temperature monitoring during haemodialysis in critically ill patients with acute kidney injury: a single-centre randomized controlled trial. Nephrol Dial Transplant. 2013;28(2):430-7.
du Cheyron, D., Terzi, N., Seguin, A., Valette, X., Prevost, F., Ramakers, M., Daubin, C., Charbonneau, P., & Parienti, J. J. (2013). Use of online blood volume and blood temperature monitoring during haemodialysis in critically ill patients with acute kidney injury: a single-centre randomized controlled trial. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 28(2), 430-7. https://doi.org/10.1093/ndt/gfs124
du Cheyron D, et al. Use of Online Blood Volume and Blood Temperature Monitoring During Haemodialysis in Critically Ill Patients With Acute Kidney Injury: a Single-centre Randomized Controlled Trial. Nephrol Dial Transplant. 2013;28(2):430-7. PubMed PMID: 22535635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of online blood volume and blood temperature monitoring during haemodialysis in critically ill patients with acute kidney injury: a single-centre randomized controlled trial. AU - du Cheyron,Damien, AU - Terzi,Nicolas, AU - Seguin,Amélie, AU - Valette,Xavier, AU - Prevost,Fabrice, AU - Ramakers,Michel, AU - Daubin,Cédric, AU - Charbonneau,Pierre, AU - Parienti,Jean-Jacques, Y1 - 2012/04/25/ PY - 2012/4/27/entrez PY - 2012/4/27/pubmed PY - 2013/8/31/medline SP - 430 EP - 7 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 28 IS - 2 N2 - BACKGROUND: Little is known about the clinical impact on cardiovascular stability during intermittent haemodialysis (IHD) for acute kidney injury (AKI) of online monitoring devices that control blood volume (BV) and blood temperature in the intensive care unit (ICU) setting. We compared different dialysis treatment modalities with or without these new systems among critically ill patients requiring IHD. METHODS: In a prospective single-centre three-arm randomized controlled trial, 600 dialysis sessions in 74 consecutive AKI critically ill patients were involved to assess intradialytic hypotension. Standard dialysis therapy with constant ultrafiltration (UF) rate, cool dialysate and high sodium conductivity (Treatment A) was compared to regimens with adjunctive interventions including BV control (Treatment B) and the combination of BV and active blood temperature control (Treatment C). Each dialysis session was randomly assigned to one of the three treatment arms and served as statistical unit. RESULTS: Five hundred and seventy-two dialysis sessions were analysed (188, 190 and 194 in Treatments A, B and C, respectively). Hypotension occurred in 16.6% treatments, with similar rates among the arms. Haemodynamic parameters and dialysis-related complications did not differ between therapies. Based on generalized estimating equation adjusted to dialysate sodium conductivity, higher Sequential Organ Failure Assessment the day of dialysis session, the need for vasopressors and lower systolic blood pressure at the onset of the session were identified as independent predictors of hypotensive episodes, whereas regimens containing the new online monitors were not. CONCLUSIONS: These results suggest that both actively controlled body temperature and UF profiled by online monitoring systems have no significant impact on the incidence of intradialytic hypotension in the ICU setting. Further research is needed before the use of these new sophisticated automatic methods can be applied routinely to the ICU setting. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/22535635/Use_of_online_blood_volume_and_blood_temperature_monitoring_during_haemodialysis_in_critically_ill_patients_with_acute_kidney_injury:_a_single_centre_randomized_controlled_trial_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfs124 DB - PRIME DP - Unbound Medicine ER -