Complications of CRRT

Q: All of the following are the complications of Continuous Renal Replacement Therapy (CRRT) except?

A) Electrolyte imbalance
B) Acid-base imbalances
C) Hypotension
D) Infection
E) Hyperthermia



Answer:  E


There are many factors which lead to hypothermia during CRRT. About 150-200 mL of blood is staying outside the body at any given time. Also, replacement fluid and dialysate are at the bedside at room temperature. Rotation of such relatively larger volume contributes to hypothermia. Clinically, this induced hypothermia comes with its own price with clotting dysfunction 3, fibrinolysis, masking of infectious fever and in some cases arrhythmias.

Hypothermia can be avoided with the use of a blood warmer in the circuit but most systems have some type of plate or convective warmer for warming the therapy fluids. 4


#nephrology
#hypothermia



References:



1. Jones SK. Loss of body heat during continuous venovenous hemodialysis (CVVHD) in critically ill patients. Blood Purif. 2003; 21:183–207. 

2. Yagi N, LeBlanc M, Sakai K, Wright EJ, Paganini EP. Cooling effect of continuous renal replacement therapy in critically ill patients. Am J Kidney Dis. 1998;32:1023–1030.

3. Wolberg AS, Meng ZH, Monroe DM III, Hoffman M. A systemic evaluation of the effect of temperature on coagulation enzyme activity and platelet function. J Trauma. 2004;56:1221–1228

4. Rickard CM, Couchman BA, Hughes M, McGrail MR. Preventing hypothermia during continuous venovenous haemodiafiltration: a randomized controlled trial. J Adv Nurs. 2004;47:393–400.