Circuit start during continuous renal replacement therapy in vasopressor-dependent patients: the impact of a slow blood flow protocol.

Abstract

In vasopressor-dependent patients, we evaluated the impact of a slow blood flow protocol on hypotension when starting continuous renal replacement therapy (CRRT).Retrospective observational study in tertiary ICU of a slow blood flow protocol at the start of CRRT circuits.205 circuits in 52 patients were studied. No significant changes in mean arterial pressure (MAP) and norepinephrine dose were found. Only 16 circuit starts in 13 patients were associated with a decrease in MAP >20%. In 23 filters and 11 patients, norepinephrine dose was >50 μg/min at baseline and also did not change significantly. There were no cardiac arrests or ventricular arrhythmias and CRRT was not discontinued because of hypotension.Implementation of a CRRT slow blood flow protocol in vasopressor-dependent patients enabled the initiation of CRRT circuits with limited hemodynamic consequences and no cardiac arrest or ventricular arrhythmia.