ABSTRACT
Objective:To evaluate the effect and safety of different heating methods in continuous renal replacement therapy (CRRT) treatment.Methods:One-hundred and twenty critical patients, who hospitalized in the department of ICU of Nanjing University of TCM affiliated Hospital from Nov. 2018 to Aug. 2020, were enrolled in this study and divided randomly and equally into four groups: control group (heated by Prismaflex′s blood warming equipment), group A (heated by spiral-wound case blood warming equipment), group B (heated by 3M Bair Hugger warming carpet) and group C (heated by 3M displacement liquid warming equipment). All the patients were monitored levels of rectal temperature, forehead temperature, and temperatures of CRRT′s arterial and venous ends in 12 hours after CRRT treatment. The rates of low or high temperature and max fluctuation range of temperature were recorded.Results:The highest temperatures of rectal, arterial and venous ends of CRRT in three groups were (37.20±0.23)℃, (37.15±0.35)℃, (37.16±0.24)℃, (37.21±0.35)℃, (37.15±0.31)℃, (37.19±0.23)℃ and (36.49±0.52)℃, (36.36±0.46)℃, (36.68±0.22)℃, respectively. After CRRT treatment, the highest temperatures of rectal in each group were (36.85±0.31)℃, (36.75±0.35)℃ and (36.96±0.21)℃, respectively. The highest temperatures of arterial and venous ends of CRRT in each group were (36.81±0.32)℃, (36.65±0.31)℃, (36.99±0.20)℃, (36.34±0.41)℃, (36.20±0.42)℃ and (36.30±0.28)℃, respectively. The highest temperatures of rectal, arterial and venous ends of CRRT in Group A and C were higher than those in control group. The highest temperatures of rectal and arterial ends of CRRT in Group A and B were lower than those in Group C ( t values were 2.037-4.559, P<0.05). After CRRT treatment, the lowest rectal temperatures in three groups were (36.85±0.31)℃, (36.75±0.35)℃ and (36.96±0.21)℃, respectively. The lowest temperatures of arterial and venous ends of CRRT in three groups were (36.81±0.32)℃, (36.65±0.31)℃, (36.99±0.20)℃, (36.34±0.41)℃, (36.20±0.42)℃ and (36.30±0.28)℃, respectively. The lowest temperatures of rectal, arterial and venous ends of CRRT in Group A and C were higher than those in control group. The lowest temperatures of rectal and arterial ends of CRRT in Group A and B were lower than those in Group C ( t values were 2.032-6.194, P<0.05). After CRRT treatment, the fluctuation of rectal temperatures in three groups were (0.34±0.11)℃, (0.38±0.15)℃ and (0.26±0.11)℃, respectively. The fluctuation of arterial and venous ends of CRRT temperatures in three groups were (0.30±0.14)℃, (0.35±0.23)℃, (0.22±0.14)℃, (0.33±0.16)℃, (0.39±0.23)℃ and (0.26±0.09)℃, respectively. The fluctuation levels of rectal, arterial and venous ends of CRRT in Group A and C were higher than those in control group. The fluctuation levels of rectal and arterial ends of CRRT in Group A and B were lower than those in Group C ( t values were 2.032-6.194, P<0.05). After CRRT treatment, the fluctuation of △RBC in three groups were 0.11±0.07, 0.11±0.06 and 0.09±0.06, respectively. The fluctuation of △Fib in three groups were 0.83±0.32, 0.84±0.28 and 0.60±0.31, respectively. Correlation analysis showed C methods was most related with the fluctuation temperatures of venous ends of CRRT. Conclusion:Heating replacement fluid by 3M blood warming device is proved to be the best way to prevent heat loss in CRRT treatment.