ISSN: 1859 - 2872
Technical characteristics of continuous renal replacement therapy (CRRT) in patients with acute and advanced heart failure
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Abstract
Objective: To describe the technical characteristics of continuous renal replacement therapy (CRRT) in patients with acute and advanced heart failure. Subject and method: A cross-sectional study was conducted on 60 patients diagnosed with acute and advanced heart failure who were indicated for continuous renal replacement therapy (CRRT) at the Cardiovascular Intensive Care Unit, Heart Institute, 108 Military Central Hospital, from May 2023 to December 2024. Clinical and paraclinical parameters, along with CRRT technical features including blood flow rate (BF), ultrafiltration rate (UF), replacement and dialysate fluid flow rates, treatment duration, and complications were recorded and analyzed. Result: The mean age of patients was 69.1 ± 13.9 years, with males comprising 65%. Cardiogenic shock was observed in 33.4% of cases, most commonly associated with acute decompensated heart failure. Oliguria or anuria was present in 45% of patients at admission. The median NT-proBNP level was 13,913pg/mL, and the mean left ventricular ejection fraction (LVEF) was 35.17%. Regarding CRRT parameters, the mean blood flow rate was 114.29mL/min, ultrafiltration rate was 140mL/h, and the replacement and dialysate flow rates were 857.14 ± 222.54mL/h and 971.43 ± 75.59mL/h, respectively. Complications included bleeding (11.7%) and infections (1.7%). Other complications, such as catheter dislodgement and filter clotting, were infrequent (1.7%). Conclusion: CRRT is an effective supportive therapy for managing patients with acute and severe decompensated heart failure, especially in cases of fluid overload and acute kidney injury. The indication and adjustment of technical parameters should be individualized according to the patient's hemodynamic status and therapeutic goals
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References
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