QUT ePrints

Preventing hypothermia during continuous veno-venous haemodiafiltration: a randomized controlled trial

Rickard, Claire M., Couchman, Bronwyn A., Hughes, Marissa, & McGrail, Matthew R. (2004) Preventing hypothermia during continuous veno-venous haemodiafiltration: a randomized controlled trial. Journal of Advanced Nursing, 47(4), pp. 393-400.

View at publisher

Abstract

Background. Continuous veno-venous haemodiafiltration is a common form of dialysis used in intensive care units. Unfortunately, patients often experience hypothermia as a side-effect of the therapy because of the necessity for extracorporeal blood flow. Intensive care nurses aim to prevent hypothermia developing. Intravenous fluid warmers are sometimes added to the dialysis circuit in an attempt to maintain patient temperature. However, the efficacy of this method has not been previously studied. Aim. This paper reports a study to investigate whether intravenous fluid warmers prevent hypothermia during continuous veno-venous haemodiafiltration. Method. A prospective randomized controlled trial was carried out in the intensive care unit of a metropolitan, tertiary-referral, teaching hospital. After Ethics Committee approval, 60 circuits in continuous veno-venous haemodiafiltration mode (200 mL/minute blood flow, 1 L/hour countercurrent dialysate, 3 L/hour pump-controlled ultrafiltration and prefilter fluid replacement of 1.7-2.0 L/hour) were studied. Circuits were randomized to have either an intravenous fluid warmer set at 38.5 degrees Celsius on the dialysate and 1 L/hour of replacement fluid lines or no fluid warmer. Patient core temperature was recorded at baseline and then hourly. Hypothermia was defined as a core temperature <36.0 degrees Celsius. Results. Mean core temperature loss did not vary between circuits with or without a fluid warmer (0.92 degrees Celsius vs. 1.11 degrees Celsius, P = 0.339). Survival analysis found no difference in hypothermia incidence between groups (log rank = 0.47, d.f. = 1, P = 0.491). Lower baseline temperature (RR 0.142, 95% CI 0.044, 0.459, P = 0.001) and female gender (RR 0.185, 95% CI 0.060, 0.573, P = 0.003) were significant risks for hypothermia. Conclusions. Intravenous fluid warmers used as described do not prevent hypothermia during continuous veno-venous haemodiafiltration. Female patients and those with a low-normal baseline temperature are most likely to become hypothermic during this form of dialysis. Further research is needed to address effective ways of preventing hypothermia in critically ill patients receiving continuous renal replacement therapies.

Impact and interest:

8 citations in Scopus
Search Google Scholar™
9 citations in Web of Science®

Citation countsare sourced monthly from Scopus and Web of Science® citation databases.

These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.

Citations counts from the Google Scholar™ indexing service can be viewed at the linked Google Scholar™ search.

Full-text downloads:

1,470 since deposited on 13 Oct 2005
236 in the past twelve months

Full-text downloadsdisplays the total number of times this work’s files (e.g., a PDF) have been downloaded from QUT ePrints as well as the number of downloads in the previous 365 days. The count includes downloads for all files if a work has more than one.

ID Code: 1569
Item Type: Journal Article
DOI: 10.1111/j.1365-2648.2004.03117.x
ISSN: 0309-2402
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Secondary (Acute Care) (111003)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2004 Blackwell Publishing
Copyright Statement: The definitive version is available at www.blackwell-synergy.com
Deposited On: 13 Oct 2005
Last Modified: 09 Jun 2010 22:25

Export: EndNote | Dublin Core | BibTeX

Repository Staff Only: item control page