Risk factors of unplanned disconnection of continuous renal replacement therapy in critically ill patients
Objective To investigate the risk factors for unplanned disconnection of continuous renal replacement therapy(CRRT)in critically ill patients.Methods A total of 320 patients who received CRRT in Department of Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University and Cangnan County People's Hospital from January 2022 to June 2023 were enrolled in the study,including 148 cases with unplanned disconnection of CRRT(treatment time＜24 h),and 172 cases with planned disconnection(treatment time ≥24 h).The clinical characteristics of the two groups were compared,and the risk factors for unplanned disconnection of CRRT were analyzed with multivariate logistic regression.Results There were significant differences in average treatment volume per hour,insufficiency of blood flow,autocirculation,comorbid liver disease,anticoagulation,dilution ratio of the preplacement fluid,pre-filling lines and filters with heparin saline,levels of APTT and free calcium ions,infusion of blood products or fat emulsion,the use of the ventilator,sedative medication,and body temperature＜36 ℃ were between two groups(all P＜0.05).Multivariate logistic regression analysis showed that high average treatment volume per hour,insufficient blood flow,no anticoagulation,no pre-filling lines and filters with heparin saline,low APTT,and body temperature ≥36 ℃ were independent risk factors for unplanned disconnection of CRRT in critically ill patients(all P＜0.05).Conclusion High average treatment volume per hour,insufficient blood flow,absence of anticoagulation,absence of heparin saline pre-filling lines and filters,low APTT and absence of body temperature below 36 ℃ are risk factors of unplanned CRRT disconnection for critically ill patients.
万方数据
维普
