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An Innovative Approach to Minimizing Downtime in Continuous Kidney Replacement Therapy
Continuous kidney replacement therapy (CKRT) is often utilized to stabilize patients with severe acute kidney injury associated with significant electrolyte abnormalities and/or oliguria and concomitant fluid accumulation. Circuit downtime may reduce daily treatment time and affect delivered doses o...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226470/ https://www.ncbi.nlm.nih.gov/pubmed/36976305 http://dx.doi.org/10.1097/MAT.0000000000001928 |
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author | Treu, Denny Ashenuga, Michael Massingham, Kara Brugger, James Medina, Luis Ficociello, Linda H. Thompson, David |
author_facet | Treu, Denny Ashenuga, Michael Massingham, Kara Brugger, James Medina, Luis Ficociello, Linda H. Thompson, David |
author_sort | Treu, Denny |
collection | PubMed |
description | Continuous kidney replacement therapy (CKRT) is often utilized to stabilize patients with severe acute kidney injury associated with significant electrolyte abnormalities and/or oliguria and concomitant fluid accumulation. Circuit downtime may reduce daily treatment time and affect delivered doses of CKRT. Studies have found clotting to be the leading cause of downtime and underdosing, which are associated with negative treatment outcomes. The NxStage Cartridge Express with Speedswap (NxStage Medical, Inc.) was designed to minimize downtime by allowing filter priming to occur in parallel with ongoing CKRT and by permitting filter exchanges without the need to replace the entire cartridge. Data from pilot studies suggest that filter exchanges using this system interrupt treatment by an average of 4 minutes per exchange—a considerable reduction from traditional systems that require treatment to be discontinued while the filter is primed, which can take 30 minutes or more. In addition to increasing patient time on therapy, this system has the potential to reduce costs for patients who require a high number of filter changes, and reduce nursing labor and environmental impact (reduced plastic waste). Future studies should confirm whether patients at higher risk of clotted/clogged filters benefit from CKRT with a system designed for rapid filter changes. |
format | Online Article Text |
id | pubmed-10226470 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-102264702023-05-30 An Innovative Approach to Minimizing Downtime in Continuous Kidney Replacement Therapy Treu, Denny Ashenuga, Michael Massingham, Kara Brugger, James Medina, Luis Ficociello, Linda H. Thompson, David ASAIO J Renal/Extracorporeal Blood Treatment Continuous kidney replacement therapy (CKRT) is often utilized to stabilize patients with severe acute kidney injury associated with significant electrolyte abnormalities and/or oliguria and concomitant fluid accumulation. Circuit downtime may reduce daily treatment time and affect delivered doses of CKRT. Studies have found clotting to be the leading cause of downtime and underdosing, which are associated with negative treatment outcomes. The NxStage Cartridge Express with Speedswap (NxStage Medical, Inc.) was designed to minimize downtime by allowing filter priming to occur in parallel with ongoing CKRT and by permitting filter exchanges without the need to replace the entire cartridge. Data from pilot studies suggest that filter exchanges using this system interrupt treatment by an average of 4 minutes per exchange—a considerable reduction from traditional systems that require treatment to be discontinued while the filter is primed, which can take 30 minutes or more. In addition to increasing patient time on therapy, this system has the potential to reduce costs for patients who require a high number of filter changes, and reduce nursing labor and environmental impact (reduced plastic waste). Future studies should confirm whether patients at higher risk of clotted/clogged filters benefit from CKRT with a system designed for rapid filter changes. Lippincott Williams & Wilkins 2023-03-28 2023-06 /pmc/articles/PMC10226470/ /pubmed/36976305 http://dx.doi.org/10.1097/MAT.0000000000001928 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASAIO. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/) ), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Renal/Extracorporeal Blood Treatment Treu, Denny Ashenuga, Michael Massingham, Kara Brugger, James Medina, Luis Ficociello, Linda H. Thompson, David An Innovative Approach to Minimizing Downtime in Continuous Kidney Replacement Therapy |
title | An Innovative Approach to Minimizing Downtime in Continuous Kidney Replacement Therapy |
title_full | An Innovative Approach to Minimizing Downtime in Continuous Kidney Replacement Therapy |
title_fullStr | An Innovative Approach to Minimizing Downtime in Continuous Kidney Replacement Therapy |
title_full_unstemmed | An Innovative Approach to Minimizing Downtime in Continuous Kidney Replacement Therapy |
title_short | An Innovative Approach to Minimizing Downtime in Continuous Kidney Replacement Therapy |
title_sort | innovative approach to minimizing downtime in continuous kidney replacement therapy |
topic | Renal/Extracorporeal Blood Treatment |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226470/ https://www.ncbi.nlm.nih.gov/pubmed/36976305 http://dx.doi.org/10.1097/MAT.0000000000001928 |
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