Evaluation of Ratio of Re-introduction of Continuous Renal Replacement Therapy in Presence or Absence of Mechanical Ventilator Support

Abstract

Acute kidney injury (AKI) is a frequent and severe complication after cardiovascular surgery. Indications of continuous renal replacement therapy (CRRT) for patients with AKI have been proposed. However, there is often less discussion of when to discontinue CRRT as well as what conditions are required for transferring to intermittent hemodialysis (HD). In this retrospective study of electronic medical records, we examined on the effects between presence or absence of mechanical ventilator support and re-introduction of CRRT in patients with AKI. When CRRT was stopped, 32 patients were supported with a mechanical ventilator while 41 patients had no support. The rate of change in body weight after the surgery were higher, sequential organ failure assessment (SOFA) score was higher and central venous pressures were higher in patients supported with a ventilator (all were p＜0.05). The rate of re-introduction to CRRT was higher (p＜0.01) in patients supported with a ventilator. The adjusted odds ratio to re-introduction was 5.20 (95%CI: 1.15～23.4). These data suggest that the presence or absence of mechanical ventilator support in addition to evaluation of renal function should be considered when CRRT is discontinued.