Research

Annals of Intensive Care

, 2:40

Open Access This content is freely available online to anyone, anywhere at any time.

Benefits of an early cooling phase in continuous renal replacement therapy for ICU patients

  • René RobertAffiliated withDepartment of Critical Care Medicine, University of Poitiers, CHUINSERM Unit U1082, University of Poitiers, CHUService de Réanimation Médicale, CHU Poitiers, Hôpital Jean Bernard Email author 
  • , Jean-Eudes MéhaudAffiliated withDepartment of Critical Care Medicine, University of Poitiers, CHUDepartment of Anesthesiology, Centre Hospitalier de Pau
  • , Najette TimrichtAffiliated withDepartment of Critical Care Medicine, University of Poitiers, CHU
  • , Véronique GoudetAffiliated withDepartment of Critical Care Medicine, University of Poitiers, CHU
  • , Olivier MimozAffiliated withDepartment of Critical Care Medicine, University of Poitiers, CHUINSERM ERI 23, University of Poitiers, CHU
  • , Bertrand DebaeneAffiliated withDepartment of Critical Care Medicine, University of Poitiers, CHU

Abstract

Background

Lowering the temperature setting in the heating device during continuous venovenous hemofiltration (CVVH) is an option. The purpose of this study was to determine the effects on body temperature and hemodynamic tolerance of two different temperature settings in the warming device in patients treated with CVVH.

Methods

Thirty patients (mean age: 66.5 years; mean SAPS 2: 55) were enrolled in a prospective crossover randomized study. After a baseline of 2 h at 38°C, the heating device was randomly set to 38°C (group A) and 36°C (group B) for 6 h. Then, the temperatures were switched to 36°C in group A and to 38°C in group B for another 6 h. Hemodynamic parameters and therapeutic interventions to control the hemodynamics were recorded.

Results

There was no significant change in body temperature in either group. During the first 6 h, group B patients showed significantly increased arterial pressure (p = 0.01) while the dosage of catecholamine was significantly decreased (p = 0.04). The number of patients who required fluid infusion or increase in catecholamine dosage was similar. During the second period of the study, hemodynamic parameters were unchanged in both groups.

Conclusions

In patients undergoing CVVH, warming of the substitute over 36°C had no impact on body temperature. We showed that setting the fluid temperature at 36°C for a period of time early in the procedure is beneficial in terms of increased mean arterial pressure and decreased catecholamine infusion dosage.

Keywords

Renal replacement therapy Hemofiltration Hemodynamic Rewarming device Temperature