Implementing a practice change: early initiation of continuous renal replacement therapy during neonatal extracorporeal life support standardizes care and improves short-term outcomes

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
Heidi J MurphyJames R Kiger

Abstract

We hypothesized that a standardized approach to early continuous renal replacement therapy (CRRT) during neonatal extracorporeal life support (ECLS) results in greater homogeneity of CRRT initiation times with improvements in fluid balance and outcomes. Retrospective analysis of data (2007-2015) obtained from neonates treated prior to (E1; n = 32) and after (E2; n = 31) a 2011 practice change: CRRT initiation within 48 h of ECLS. Birthweight, gestational age, ECLS mode, and age at ECLS initiation were similar to each epoch. Survival [E1: median 75%, E2: 71%] and length of ECLS [E1: median 221 h, E2: 180 h] were comparable. During E2, 100% of infants received CRRT (vs. E1: 37%; p < 0.001) and 97% of infants initiated CRRT within 48 h of ECLS (vs. E1: 13%; p < 0.001). Control charts demonstrate reduced practice variation. Elapsed time from ECLS to CRRT differed between Epochs [E1: median 105 h, E2: 9 h; p < 0.001] as did weight at CRRT initiation [E1: 4.13 kg (29% above baseline), E2: 3.19 kg (0%); p < 0.001]. Significant differences in weight change were noted on days 6 and 7 (E1: 14%, E2: 2%; raw data comparison yielded p < 0.05) and curves were different (p < 0.05). We successfully implemented a practice change, initiating CRR...Continue Reading

References

Sep 11, 1991·Journal of Pediatric Surgery·R E KellyT R Hall
Feb 29, 2000·Journal of Pediatric Surgery·F SwanikerR Hirschl
Apr 7, 2009·Critical Care : the Official Journal of the Critical Care Forum·Karin BlijdorpDick Tibboel
Apr 22, 2009·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Andrew H SmithMary B Taylor
Jan 1, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Scott M SutherlandStuart L Goldstein
Mar 31, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·David J AskenaziReed A Dimmitt
May 11, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Matthew L PadenJames D Fortenberry
Apr 19, 2011·Journal of Pediatric Surgery·Samir K GadepalliGeorge B Mychaliska
May 17, 2012·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Geoffrey M FlemingMichael Zappitelli
Jul 26, 2013·Critical Care : the Official Journal of the Critical Care Forum·Alexandra J M ZwiersKarlien Cransberg
Aug 7, 2013·The Annals of Thoracic Surgery·Michael J WolfWilliam T Mahle
Aug 24, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jordan Matthew SymonsDavid Michael McMullan
Nov 16, 2013·Critical Care Medicine·Vinai ModemRaymond Quigley
Dec 9, 2014·Critical Care : the Official Journal of the Critical Care Forum·Han ChenJian-Xin Zhou
May 18, 2016·The New England Journal of Medicine·Stéphane GaudryUNKNOWN AKIKI Study Group
Oct 19, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Geoffrey M FlemingDavid S Cooper
Mar 8, 2017·Critical Care : the Official Journal of the Critical Care Forum·Myles SmithHergen Buscher
Oct 2, 2017·Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation·Heidi J MurphyJames R Kiger

❮ Previous
Next ❯

Citations

Feb 24, 2019·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Y SawaT Yamaoka
Apr 6, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Heidi J Murphy, David T Selewski
Jul 26, 2019·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Heidi J MurphyDavid J Annibale
Jan 19, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Stephen M GorgaDavid T Selewski
Jul 17, 2020·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Sven MaierChristoph Benk
Mar 26, 2021·Seminars in Dialysis·David T Selewski, Keith M Wille
Aug 21, 2021·International Journal of Nephrology and Renovascular Disease·Lorenzo FotiZaccaria Ricci

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation
Heidi J MurphyJames R Kiger
Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
Péter VargaÁkos Gasparics
Irish Medical Journal
M J Turner, N Farah
© 2022 Meta ULC. All rights reserved