Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Treu, Denny, Ashenuga, Michael, Massingham, Kara, Brugger, James, Medina, Luis, Ficociello, Linda H., Thompson, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
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
_version_ 1785050582547955712
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
work_keys_str_mv AT treudenny aninnovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT ashenugamichael aninnovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT massinghamkara aninnovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT bruggerjames aninnovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT medinaluis aninnovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT ficociellolindah aninnovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT thompsondavid aninnovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT treudenny innovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT ashenugamichael innovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT massinghamkara innovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT bruggerjames innovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT medinaluis innovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT ficociellolindah innovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy
AT thompsondavid innovativeapproachtominimizingdowntimeincontinuouskidneyreplacementtherapy