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Critical Care Research and Practice
Volume 2012 (2012), Article ID 869237, 9 pages
http://dx.doi.org/10.1155/2012/869237
Clinical Study

Variability in Uremic Control during Continuous Venovenous Hemodiafiltration in Trauma Patients

1Division of Emergencies and Critical Care, Department of Anesthesiology, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway
2Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, Norway
3Department of Informatics, Oslo Hospital Services, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway
4Division of Medicine, Department of Nephrology, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway

Received 8 December 2011; Revised 12 February 2012; Accepted 27 February 2012

Academic Editor: Olivier Joannes-Boyau

Copyright © 2012 Sigrid Beitland et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Acute kidney injury (AKI) necessitating continuous renal replacement therapy (CRRT) is a severe complication in trauma patients (TP). We wanted to assess daily duration of CRRT and its impact on uremic control in TP. Material and Methods. We retrospectively reviewed adult TP, with or without rhabdomyolysis, with AKI undergoing CRRT. Data on daily CRRT duration and causes for temporary stops were collected from the first five CRRT days. Uremic control was assessed by daily changes in serum urea ( Δ urea) and creatinine ( Δ creatinine) concentrations. Results. Thirty-six TP were included with a total of 150 CRRT days, 17 (43%) with rhabdomyolysis. The median (interquartile range (IQR)) time per day with CRRT was 19 (15–21) hours. There was a significant correlation between daily CRRT duration and Δ urea ( 𝑟 = 0 . 6 0 , 𝑃 0 . 0 0 1 ) and Δ creatinine ( 𝑟 = 0 . 4 3 ; 𝑃 = 0 . 0 1 2 ). CRRT pauses were caused by filter clotting (54%), therapeutic interventions (25%), catheter related problems (10%), filter timeout (6%), and diagnostic procedures (6%). Rhabdomyolysis did not affect the CRRT data. Conclusions. TP undergoing CRRT had short daily CRRT duration causing reduced uremic control. Clinicians should modify their daily clinical practice to improve technical skills and achieve sufficient dialysis dose.