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Title: Insertion side, body position and circuit life during continuous renal replacement therapy with femoral vein access.
Austin Authors: Kim, In Byung;Fealy, Nigel G ;Baldwin, Ian C ;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care Medicine, Austin Hospital, Studley Road, Melbourne, VIC 3084, Australia
Issue Date: 16-Dec-2010
Publication information: Blood Purification 2010; 31(1-3): 42-6
Abstract: Choice of insertion side and patient position during continuous renal replacement therapy (CRRT) with femoral vein vascular access may affect circuit life. We investigated if there is an association between choice of insertion side and body position and its changes and circuit life during CRRT with femoral vein access.We studied 50 patients receiving CRRT via femoral vein access with a sequential retrospective study in a tertiary intensive care unit. We defined two groups: patients with right or left femoral vein access. We then obtained information on age, gender, circuit life, total heparin dose, hemoglobin concentration and coagulation variables (platelet count, international normalized ratio, and activated partial thromboplastin time) and percentage of time each patient spent in the supine, left lying, right lying, and sitting position during treatment.We studied 341 circuits in 50 patients. Mean circuit life was 13.9 h. Of these circuits, 251 (73.6%) were treated with right femoral vein access. Mean circuit life in this group was significantly longer compared with left femoral vein access (15.0 ± 14.3 vs. 10.6 ± 7.4; p = 0.019). Percentage spent in a particular position during CRRT was not significantly different between two groups. On multivariable linear regression analysis, mean circuit life was significantly and positively correlated with right vascular access site (p = 0.03) and lower platelet count (p = 0.03), but not with patient position.Right-sided insertion but not time spent in a particular position significantly affects circuit life during CRRT with femoral vein access.
Gov't Doc #: 21160179
DOI: 10.1159/000322254
Type: Journal Article
Subjects: Adult
Anticoagulants.therapeutic use
Blood Coagulation
Cohort Studies
Equipment Failure
Femoral Vein.metabolism
International Normalized Ratio
Middle Aged
Partial Thromboplastin Time
Patient Positioning
Platelet Count
Renal Replacement Therapy.instrumentation.methods
Appears in Collections:Journal articles

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