Chinese Journal of Blood Purification ›› 2020, Vol. 19 ›› Issue (09): 645-648.doi: 10.3969/j.issn.1671-4091.2020.09.018

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Related factors of unexpected interruption of continuous renal replacement therapy in critical care patients

  

  1. 1Department of Nephrology, 2The 3rd Ward of Surgery Department, and 3Department of Critical Care Medicine, The Aerospace Central Hospital, Beijing 100049, China
  • Received:2020-02-06 Revised:2020-07-03 Online:2020-09-12 Published:2020-09-03

Abstract: 【Abstract】Objective T o explore the related factors of unexpected interruption of continuous renal replacement therapy (CRRT), and to provide the information about clinical CRRT quality management. Methods This was a prospective study using the convenient sampling method.Atotal of 159 patients undergoingCRRTdue to severe illnesses from March 2019 to June 2019 were enrolled in this study. The number of unexpected interruptions of CRRT was recorded and the related factors were analyzed. Results In the 346 CRRT treatments, 50 patientstimes of unplanned cessation of CRRT (14.45%) occurred, and the average treatment time was 19.00 ± 15.58 hours. Multivariate regression analysis revealed that venous pressure (OR=1.022, 95% CI=1.002~1.043, P=0.043), transmembrane pressure (TMP; OR=1.045, 95% CI=1.023~1.078, P=0.014), prothrombin time
(PT; OR=0.537, 95% CI=0.326~0.885, P=0.016), activated partial thromboplastin time (APTT; OR=0.502, 95% CI=0.298~0.818, P=0.019), hematocrit (OR=4.422, 95% CI=4.035~4.972, P=0.027), anticoagulation method (OR=12.611, 95% CI= 9.900 ~16.223, P=0.043), and number of nurses responsible for the machine (OR=1.021, 95% CI=0.810~1.265, P=0.001) were the risk factors for unplanned cessation of CRRT. Conclusion During the implementation of CRRT, changes of pressure value, coagulation indicators and hematocrit indicators must be carefully monitored, anticoagulants and their doses must be appropriately adjusted, and the workload of the nurses must be properly arranged to reduce the rate of unexpected interruption of CRRT.

Key words: Continuous renal replacement therapy, Unplanned cessation, Circuit life, Clotting

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