Cargando…
Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit
BACKGROUND: The introduction of a continuous renal replacement therapy (CRRT) device into the extracorporeal membrane oxygenation (ECMO) circuit is widely used. However, excessive pressure transmitted to the CRRT device is a major disadvantage. We investigated the effects of using additional pressur...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299989/ https://www.ncbi.nlm.nih.gov/pubmed/30567509 http://dx.doi.org/10.1186/s12882-018-1172-2 |
_version_ | 1783381601938309120 |
---|---|
author | Na, Soo Jin Choi, Hee Jung Chung, Chi Ryang Cho, Yang Hyun Jang, Hye Ryoun Suh, Gee Young Jeon, Kyeongman |
author_facet | Na, Soo Jin Choi, Hee Jung Chung, Chi Ryang Cho, Yang Hyun Jang, Hye Ryoun Suh, Gee Young Jeon, Kyeongman |
author_sort | Na, Soo Jin |
collection | PubMed |
description | BACKGROUND: The introduction of a continuous renal replacement therapy (CRRT) device into the extracorporeal membrane oxygenation (ECMO) circuit is widely used. However, excessive pressure transmitted to the CRRT device is a major disadvantage. We investigated the effects of using additional pressure control lines on the pressure and the lifespan of the CRRT circuit connected to the ECMO. METHODS: This is an observational study using prospectively collected data from consecutive patients receiving CRRT connected into the ECMO circuit at a university-affiliated, tertiary hospital from January 2013 to December 2016. The CRRT circuit was connected into the ECMO circuit through the Luer Lock connection without an additional pressure control line in 16 patients (9%, no line group), an additional pressure control line on the inlet line in 36 patients (23%, single line group), and additional pressure control lines on both the inlet and outlet lines in 118 patients (77%, double line group). The outcome measures of interest were compared among the three groups. RESULTS: The median access pressure was higher in the no line group compared to the groups. However, median filter pressure, effluent pressure, and return pressure were higher in the double line group compared to the other groups. There were no significant differences in platelets, lactate dehydrogenase, and plasma hemoglobin among the 3 groups over the time period studied. Median lifespan of the CRRT circuits in the double line group was 45.0 (29.0–63.7) hours, which was higher compared to 21.8 (11.6–31.8) hours in the no line group and 23.0 (15.0–34.6) hours in the single line group, respectively. In addition, in-hospital mortality was lower in the double line group (48.3%) compared to the no line group (68.8%) and the single line group (75.0%). CONCLUSIONS: Additional tubing can be considered a simple and safe method for pressure control and lengthening circuit survival when connecting the CRRT device to the ECMO circuit. |
format | Online Article Text |
id | pubmed-6299989 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-62999892018-12-20 Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit Na, Soo Jin Choi, Hee Jung Chung, Chi Ryang Cho, Yang Hyun Jang, Hye Ryoun Suh, Gee Young Jeon, Kyeongman BMC Nephrol Research Article BACKGROUND: The introduction of a continuous renal replacement therapy (CRRT) device into the extracorporeal membrane oxygenation (ECMO) circuit is widely used. However, excessive pressure transmitted to the CRRT device is a major disadvantage. We investigated the effects of using additional pressure control lines on the pressure and the lifespan of the CRRT circuit connected to the ECMO. METHODS: This is an observational study using prospectively collected data from consecutive patients receiving CRRT connected into the ECMO circuit at a university-affiliated, tertiary hospital from January 2013 to December 2016. The CRRT circuit was connected into the ECMO circuit through the Luer Lock connection without an additional pressure control line in 16 patients (9%, no line group), an additional pressure control line on the inlet line in 36 patients (23%, single line group), and additional pressure control lines on both the inlet and outlet lines in 118 patients (77%, double line group). The outcome measures of interest were compared among the three groups. RESULTS: The median access pressure was higher in the no line group compared to the groups. However, median filter pressure, effluent pressure, and return pressure were higher in the double line group compared to the other groups. There were no significant differences in platelets, lactate dehydrogenase, and plasma hemoglobin among the 3 groups over the time period studied. Median lifespan of the CRRT circuits in the double line group was 45.0 (29.0–63.7) hours, which was higher compared to 21.8 (11.6–31.8) hours in the no line group and 23.0 (15.0–34.6) hours in the single line group, respectively. In addition, in-hospital mortality was lower in the double line group (48.3%) compared to the no line group (68.8%) and the single line group (75.0%). CONCLUSIONS: Additional tubing can be considered a simple and safe method for pressure control and lengthening circuit survival when connecting the CRRT device to the ECMO circuit. BioMed Central 2018-12-19 /pmc/articles/PMC6299989/ /pubmed/30567509 http://dx.doi.org/10.1186/s12882-018-1172-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Na, Soo Jin Choi, Hee Jung Chung, Chi Ryang Cho, Yang Hyun Jang, Hye Ryoun Suh, Gee Young Jeon, Kyeongman Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit |
title | Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit |
title_full | Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit |
title_fullStr | Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit |
title_full_unstemmed | Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit |
title_short | Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit |
title_sort | using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299989/ https://www.ncbi.nlm.nih.gov/pubmed/30567509 http://dx.doi.org/10.1186/s12882-018-1172-2 |
work_keys_str_mv | AT nasoojin usingadditionalpressurecontrollineswhenconnectingacontinuousrenalreplacementtherapydevicetoanextracorporealmembraneoxygenationcircuit AT choiheejung usingadditionalpressurecontrollineswhenconnectingacontinuousrenalreplacementtherapydevicetoanextracorporealmembraneoxygenationcircuit AT chungchiryang usingadditionalpressurecontrollineswhenconnectingacontinuousrenalreplacementtherapydevicetoanextracorporealmembraneoxygenationcircuit AT choyanghyun usingadditionalpressurecontrollineswhenconnectingacontinuousrenalreplacementtherapydevicetoanextracorporealmembraneoxygenationcircuit AT janghyeryoun usingadditionalpressurecontrollineswhenconnectingacontinuousrenalreplacementtherapydevicetoanextracorporealmembraneoxygenationcircuit AT suhgeeyoung usingadditionalpressurecontrollineswhenconnectingacontinuousrenalreplacementtherapydevicetoanextracorporealmembraneoxygenationcircuit AT jeonkyeongman usingadditionalpressurecontrollineswhenconnectingacontinuousrenalreplacementtherapydevicetoanextracorporealmembraneoxygenationcircuit |