Association of continuous renal replacement therapy downtime with fluid balance gap and clinical outcomes: a retrospective cohort analysis utilizing EHR and machine data
2024

Impact of CRRT Downtime on Fluid Management and Patient Outcomes

Sample size: 500 publication 10 minutes Evidence: moderate

Author Information

Author(s): Chloe Braun, Tomonori Takeuchi, Josh Lambert, Lucas Liu, Sarah Roberts, Stuart Carter, William Beaubien-Souligny, Ashita Tolwani, Javier A. Neyra

Primary Institution: The University of Alabama at Birmingham

Hypothesis

Higher percent treatment time loss (%TTL) during continuous renal replacement therapy (CRRT) is positively associated with fluid balance gap (FBgap).

Conclusion

In critically ill patients undergoing CRRT, downtime was associated with fluid balance gap only in patients with frequent alarms, but not with hospital mortality.

Supporting Evidence

  • Patients with higher alarm frequency experienced a significant positive relationship between %TTL and FBgap.
  • Overall mortality in the cohort was 54.2%.
  • The median %TTL was 8.14%, indicating downtime during CRRT.
  • Statistical analysis showed no association between %TTL and hospital mortality.

Takeaway

If the CRRT machine is down for a long time, it can mess up how much fluid doctors want to take out of a patient, especially if there are a lot of alarms going off.

Methodology

This was a retrospective cohort study analyzing data from electronic health records and CRRT machine data to assess the relationship between %TTL and FBgap.

Potential Biases

Potential systematic errors in data mining due to reliance on matching algorithms between EHR and CRRT machine data.

Limitations

The study was limited to a single center and had a predominantly white patient population, which may affect generalizability.

Participant Demographics

Median age of participants was 59.5 years, with 61% male and 89.8% white.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI 0.48–1.26

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/s40560-024-00772-w

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