Hypothermia during CRRT, a comparative analysis

One of the most common adverse events during continuous renal replacement therapy (CRRT) is hypothermia, reported to occur in over 4/10 cases. In turn, hypothermia is known to be associated with higher mortality rates among patients treated in intensive care units (ICU). The present study examined if a novel warming device in the current generation of CRRT systems could lower incidence of hypothermia compared to previous generation technology.

We included ICU patients >18 years, at Skåne University Hospital, Lund from November 2006 to August 2019 and treated with CRRT. Temperature measurements were recorded from the CRRT systems and from the patients hourly.

In total, 310 patients treated with the older system vs 32 patients treated using the newer CRRT system were included. We found that historic Prismaflex patients spent 11.43% of their time in hypothermia, as compared to the novel Prismax CRRT system, where 10.06% of patient hours were below 36.0°C (Chi-Square P = .0063). The novel blood warmer is associated with less heat loss compared to the older warmer: mean patient temperature was 37°C vs 36.5°C for these two groups and mean set return temperature was 37.9°C vs 40.9°C (both P < .001).

The current generation CRRT system and blood warmer significantly decreases the risk of hypothermia among critically ill patients treated with continuous renal replacement therapy as compared to historic controls. Achieving target temperature is easier with the new system.