Objectives: 

To examine the effects of patient and treatment variables on circuit lifespan in critically ill children requiring continuous renal replacement therapy.

Design: 

Retrospective observational study based on a prospective registry.

Setting: 

Tertiary referral 30-bed PICU.

Patients: 

One hundred sixty-one critically ill children undergoing continuous renal replacement therapy during an 8-year period (2007–2014) were included in the study.

Interventions: 

Continuous renal replacement therapy.

Measurements and Main Results: 

During the study period, 161 patients received a total of 22,190 hours of continuous renal replacement therapy, with a median duration of 74.75 hours (interquartile range, 32–169.5) per patient. Of the 572 filter circuits used, 276 (48.3%) were changed due to circuit clotting and 262 (45.8%) were electively changed. Median circuit life was 24.62 hours (interquartile range, 10.6–55.3) for all filters and significantly longer for those electively removed as compared to those prematurely removed because of clotting (35.50 hr [interquartile range, 16.9–67.6] vs 22.00 hr [interquartile range, 13.8–42.5]; p < 0.001). Multivariate regression analyses revealed that admission diagnosis (p < 0.001), anticoagulation type (p < 0.001), access type (p = 0.016), and circuit size (p = 0.027) were associated with prolonged circuit life, as well as, in patients on heparin anticoagulation, with higher doses of heparin (p < 0.001) and a prolonged activated partial thromboplastin time (p < 0.001).

Conclusions: 

In this study, circuit lifespan in pediatric continuous renal replacement therapy was low and appeared to depend upon the patient’s diagnosis, the type of access and anticoagulation used as well as the size of the circuit used.

中文翻译：

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在重症儿童的连续肾脏替代治疗期间，与患者和治疗相关的因素对电路寿命的影响。

目标： 

要检查病人和治疗变量对影响电路的寿命在危重患儿需要连续性肾脏替代治疗。

设计： 

基于前瞻性注册表的回顾性观察研究。

设置： 

三级转诊30张床的PICU。

耐心： 

一百61危重患儿进行连续性肾脏替代治疗期间的8年间（2007- 2014年）被列入研究。

干预措施： 

持续肾脏替代治疗。

测量和主要结果： 

在研究期间，共有161名患者接受了22,190小时的连续性肾脏替代治疗，每位患者的中位持续时间为74.75小时（四分位间距为32–169.5）。在使用的572个滤波器电路中，有276个（48.3％）因电路凝结而发生了变化，有262个（45.8％）因选择了电路而发生了变化。所有过滤器的中位电路寿命为24.62小时（四分位数范围，10.6-55.3），与由于凝结而过早去除的那些相比，有选择地移除的那些相比，有选择地去除的那些明显更长（35.50 hr [四分位数范围，16.9–67.6] vs 22.00 hr（四分位数范围） ，13.8–42.5]；p <0.001）。多元回归分析表明，入院诊断（p <0.001），抗凝类型（p<0.001），通路类型（p = 0.016）和回路大小（p = 0.027）与延长回路寿命以及肝素抗凝患者中较高剂量的肝素（p <0.001）和延长的回路寿命相关激活部分凝血活酶时间（p <0.001）。

结论： 

在这项研究中，小儿连续性肾脏替代治疗的回路寿命很短，并且似乎取决于患者的诊断，所用通路和抗凝的类型以及所用回路的大小。