![]() Majority of studies are observational or report circuit factors in sub-analysis. Patient factors associated with a statistically significant worsening of filter life included mechanical ventilation, elevated SOFA or LOD score, elevations in ionized calcium, elevated platelet count, red cell transfusion, platelet factor 4 (PF-4) antibodies, and elevated fibrinogen. There is insufficient data to determine advantages of haemofilter membranes. There was a trend favouring higher blood flow rates. There is inconsistency in the difference reported between femoral and jugular catheters.Īmongst published literature, modality of CRRT consistently favoured continuous veno-venous haemodiafiltration (CVVHD-F) with an associated 44% lower failure rate compared to CVVH. Ranking of vascular access site by filter longevity favours: tunnelled semi-permanent catheters, femoral, internal jugular and subclavian last. Risk of bias was high and findings are hypothesis generating. 24 presented data on patient modifiers of circuit life, 14 on vascular access modifiers and 34 on circuit related factors. ResultsĮight hundred nineteen abstracts were identified of which 364 were selected for full text analysis. All studies comparing anticoagulation interventions were searched for regression or hazard models pertaining to other sources of variation in filter life. Included studies documented filter life in hours with a comparator other than anti-coagulation intervention. MethodsĪ systematic review and meta-analysis was performed by searching Pubmed (MEDLINE) and Ovid EMBASE libraries from inception to 29 th February 2016 for all studies with a comparator or independent variable relating to CRRT circuits and reporting filter life. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. ![]()
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