Interruptions and downtime of continuous renal replacement therapy in critically ill adults: A retrospective observational study.
Zhen-Hua Zhao, Lin Yu, Li-Hua Qiu and 6 others
PMID 40022503WHAT IT FOUND
CRRT circuits stopped often.
Each circuit had 67 interruptions on average and a median of 1.98 hours of downtime. Bag changes caused most downtime, and passive bag change caused more downtime than active bag change.
Key findings
01Across 143 CRRT circuits, each circuit had 67 interruptions on average, median circuit downtime was 1.98 hours, and median downtime proportion was 4.58%.
02Bag changes caused the most circuit downtime, averaging 1.17 hours; passive bag change caused 1.11 hours of downtime versus 0.05 hours for active bag change.
03In circuits with downtime proportion >10%, alarms occurred 45.54 ±42.87 times and took 113.03 ±33.86 seconds on average to repair, and 53.85% had examinations or surgeries outside the ICU.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single ICU in China, so results may not apply to other units or machines. Only Prismaflex circuits were analysed, although the unit used three machine types. Small sample: 59 patients and 143 circuits. No intervention was tested; the study only observed interruptions and downtime. Data were collected in 2019-2020 and analysed later. Downtime of circuit exchange was not included. No patient outcomes were measured.
Declared interests
Funded by Project of Modern Hospital Management and Development Institute, Nanjing University, and Aid project of Nanjing Drum Tower Hospital Health, Education & Research Foundation. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that changing bags early or responding faster will reduce downtime or improve patient outcomes. This was an observational study and did not test these actions.