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Open Access Research

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

René Robert125*, Jean-Eudes Méhaud13, Najette Timricht1, Véronique Goudet1, Olivier Mimoz14 and Bertrand Debaene1

Author Affiliations

1 Department of Critical Care Medicine, University of Poitiers, CHU, Poitiers, F86000, France

2 INSERM Unit U1082, University of Poitiers, CHU, Poitiers, F86000, France

3 Department of Anesthesiology, Centre Hospitalier de Pau, Pau, F64000, France

4 INSERM ERI 23, University of Poitiers, CHU, Poitiers, F86000, France

5 Service de Réanimation Médicale, CHU Poitiers, Hôpital Jean Bernard, Poitiers Cedex, 86021, France

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Annals of Intensive Care 2012, 2:40  doi:10.1186/2110-5820-2-40

Published: 23 August 2012

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