Cargando…

The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature

Background: Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia,...

Descripción completa

Detalles Bibliográficos
Autores principales: Mendrala, Konrad, Kosiński, Sylweriusz, Podsiadło, Paweł, Pasquier, Mathieu, Paal, Peter, Mazur, Piotr, Darocha, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467292/
https://www.ncbi.nlm.nih.gov/pubmed/34574562
http://dx.doi.org/10.3390/ijerph18189638
_version_ 1784573360064167936
author Mendrala, Konrad
Kosiński, Sylweriusz
Podsiadło, Paweł
Pasquier, Mathieu
Paal, Peter
Mazur, Piotr
Darocha, Tomasz
author_facet Mendrala, Konrad
Kosiński, Sylweriusz
Podsiadło, Paweł
Pasquier, Mathieu
Paal, Peter
Mazur, Piotr
Darocha, Tomasz
author_sort Mendrala, Konrad
collection PubMed
description Background: Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia, below or equal to 32 °C. Methods: This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (identifier CRD42021232821). We searched Embase, Medline, and Cochrane databases using the keywords hypothermia, renal replacement therapy, hemodialysis, hemofiltration, hemodiafiltration, and their abbreviations. The search included only articles in English with no time limit, up until 30 June 2021. Results: From the 795 revised articles, 18 studies including 21 patients, were selected for the final assessment and data extraction. The mean rate of rewarming calculated for all studies combined was 1.9 °C/h (95% CI 1.5–2.3) and did not differ between continuous (2.0 °C/h; 95% CI 0.9–3.0) and intermittent (1.9 °C/h; 95% CI 1.5–2.3) methods (p > 0.9). Conclusions: Based on the reviewed literature, it is currently not possible to provide high-quality recommendations for RRT use in specific groups of patients in accidental hypothermia. While RRT appears to be a viable rewarming strategy, the choice of rewarming method should always be determined by the specific clinical circumstances, the available resources, and the current resuscitation guidelines.
format Online
Article
Text
id pubmed-8467292
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-84672922021-09-27 The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature Mendrala, Konrad Kosiński, Sylweriusz Podsiadło, Paweł Pasquier, Mathieu Paal, Peter Mazur, Piotr Darocha, Tomasz Int J Environ Res Public Health Viewpoint Background: Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia, below or equal to 32 °C. Methods: This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (identifier CRD42021232821). We searched Embase, Medline, and Cochrane databases using the keywords hypothermia, renal replacement therapy, hemodialysis, hemofiltration, hemodiafiltration, and their abbreviations. The search included only articles in English with no time limit, up until 30 June 2021. Results: From the 795 revised articles, 18 studies including 21 patients, were selected for the final assessment and data extraction. The mean rate of rewarming calculated for all studies combined was 1.9 °C/h (95% CI 1.5–2.3) and did not differ between continuous (2.0 °C/h; 95% CI 0.9–3.0) and intermittent (1.9 °C/h; 95% CI 1.5–2.3) methods (p > 0.9). Conclusions: Based on the reviewed literature, it is currently not possible to provide high-quality recommendations for RRT use in specific groups of patients in accidental hypothermia. While RRT appears to be a viable rewarming strategy, the choice of rewarming method should always be determined by the specific clinical circumstances, the available resources, and the current resuscitation guidelines. MDPI 2021-09-13 /pmc/articles/PMC8467292/ /pubmed/34574562 http://dx.doi.org/10.3390/ijerph18189638 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Viewpoint
Mendrala, Konrad
Kosiński, Sylweriusz
Podsiadło, Paweł
Pasquier, Mathieu
Paal, Peter
Mazur, Piotr
Darocha, Tomasz
The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature
title The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature
title_full The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature
title_fullStr The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature
title_full_unstemmed The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature
title_short The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature
title_sort efficacy of renal replacement therapy for rewarming of patients in severe accidental hypothermia—systematic review of the literature
topic Viewpoint
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467292/
https://www.ncbi.nlm.nih.gov/pubmed/34574562
http://dx.doi.org/10.3390/ijerph18189638
work_keys_str_mv AT mendralakonrad theefficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT kosinskisylweriusz theefficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT podsiadłopaweł theefficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT pasquiermathieu theefficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT paalpeter theefficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT mazurpiotr theefficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT darochatomasz theefficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT mendralakonrad efficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT kosinskisylweriusz efficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT podsiadłopaweł efficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT pasquiermathieu efficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT paalpeter efficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT mazurpiotr efficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature
AT darochatomasz efficacyofrenalreplacementtherapyforrewarmingofpatientsinsevereaccidentalhypothermiasystematicreviewoftheliterature