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Optimising filter lifespan in critically ill patients with coronavirus disease (COVID-19) receiving renal replacement therapy (RRT): an observational study in a UK district general hospital
Critical Care ; 26(SUPPL 1), 2022.
Article in English | EMBASE | ID: covidwho-1793891
ABSTRACT

Introduction:

Evidence shows COVID-19 patients requiring RRT have an increased incidence of filter cartridge failure [1], this study aimed to reduce filter changes using an increased citrate dose protocol. Frequent filter changes can lead to reduced therapy delivery, increased cost and anaemia, however, the benefits of preserving filter lifespan must be balanced against the risks of anticoagulation associated bleeding.

Methods:

A retrospective observational study was performed of our COVID-19 patients requiring RRT using an increased citrate presciption of 4 mmol/l and continuous venovenous haemodiafiltration (CVVHDF).

Results:

The unit treated 106 patients with COVID 19 of whom 15 required RRT. 8 patients were managed exclusively on the adjusted protocol. The median duration spent on RRT was 188 h. The average lifespan of a filter in COVID-19 patient was improved from 37 to 45 h using the increased citrate protocol. There were no adverse bleeding outcomes and no documented evidence of citrate toxicity.

Conclusions:

This small study showed an improved filter life for patients on an increased citrate dose protocol of CVVHDF without any adverse outcomes. This results in cost savings and more appropriate resource usage during a pandemic without increased bleeding risk. Another suggested measure to reduce filter malfunctions was that centres returned to using heparin anticoagulation but this is known to have increased bleeding risk [2]. Further research in a larger cohort is required but this is a promising improvement in a complex patient group.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study / Prognostic study Language: English Journal: Critical Care Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study / Prognostic study Language: English Journal: Critical Care Year: 2022 Document Type: Article