Dissemin is shutting down on January 1st, 2025

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Karger Publishers, Blood Purification, 1-3(41), p. 11-17, 2015

DOI: 10.1159/000439581

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Femoral Access and Delivery of Continuous Renal Replacement Therapy Dose

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

<b><i>Aims:</i></b> The study aims to describe the use of dialysis catheters in critically ill patients treated with continuous renal replacement therapy (CRRT) and to study the impact of femoral versus non-femoral access on CRRT dose. <b><i>Methods:</i></b> Statistical analysis and predictive modelling of data from the Randomized Evaluation of Normal vs. Augmented Level renal replacement therapy trial. <b><i>Results:</i></b> The femoral vein was the first access site in 937 (67%) of 1,399 patients. These patients had higher Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores (p = 0.009) and lower pH (p < 0.001) but similar mortality to patients with non-femoral access (44 vs. 45%; p = 0.63). Lower body weight was independently associated with femoral access placement (OR 0.97, 95% CI 0.96-0.98). Femoral access was associated with a 1.03% lower CRRT dose (p = 0.05), but a 4.20% higher dose was achieved with 13.5 Fr catheters (p = 0.03). <b><i>Conclusions:</i></b> Femoral access was preferred in lighter and sicker patients. Catheter gauge had greater impact than catheter site in CRRT dose delivery. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=439581.