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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Annals of Intensive Care 1/2012

Benefits of an early cooling phase in continuous renal replacement therapy for ICU patients

Zeitschrift:
Annals of Intensive Care > Ausgabe 1/2012
Autoren:
René Robert, Jean-Eudes Méhaud, Najette Timricht, Véronique Goudet, Olivier Mimoz, Bertrand Debaene
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​2110-5820-2-40) contains supplementary material, which is available to authorized users.

Competing interest

The authors declare that they have no competing interests.

Authors’ contribution

RR and JEM conceived of the study and participated in its design and coordination. RR and JEM performed the associated experimental study. RR, JEM, NT, and VG were responsible for inclusion of the patients and data collection. RR, JEM, NT, and VGperformed the statistical analysis and drafted the manuscript. OM and BG helped with the conception of the study and reviewed the manuscript. RR, JEM, and NT: conception of the study, interpretation of data. JEM, NT, VG: in charge of inclusions, data management. RR, JEM: drafting the manuscript. RR, OM, BD: revision of the manuscript. All authors read and approved the final manuscript.

Abstract

Background

Lowering the temperature setting in the heating device during continuous venovenous hemofiltration (CVVH) is an option. The purpose of this study was to determine the effects on body temperature and hemodynamic tolerance of two different temperature settings in the warming device in patients treated with CVVH.

Methods

Thirty patients (mean age: 66.5 years; mean SAPS 2: 55) were enrolled in a prospective crossover randomized study. After a baseline of 2 h at 38°C, the heating device was randomly set to 38°C (group A) and 36°C (group B) for 6 h. Then, the temperatures were switched to 36°C in group A and to 38°C in group B for another 6 h. Hemodynamic parameters and therapeutic interventions to control the hemodynamics were recorded.

Results

There was no significant change in body temperature in either group. During the first 6 h, group B patients showed significantly increased arterial pressure (p = 0.01) while the dosage of catecholamine was significantly decreased (p = 0.04). The number of patients who required fluid infusion or increase in catecholamine dosage was similar. During the second period of the study, hemodynamic parameters were unchanged in both groups.

Conclusions

In patients undergoing CVVH, warming of the substitute over 36°C had no impact on body temperature. We showed that setting the fluid temperature at 36°C for a period of time early in the procedure is beneficial in terms of increased mean arterial pressure and decreased catecholamine infusion dosage.
Zusatzmaterial
Authors’ original file for figure 1
13613_2012_106_MOESM1_ESM.jpeg
Literatur
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