title: Cost analysis of blood purification in intensive care units: continuous versus intermittent hemodiafiltration.
abstract: BACKGROUND
  We implemented a program for continuous renal replacement therapies (CRRT) in intensive care units (ICU) based on the cooperative work of dialysis and ICU personnel. Our aim was to report the main details of this program and compare its cost with that of intermittent hemodiafiltration (IHDF).
  
  
  METHODS
  The study referred to 181 ICU patients with renal failure. We considered the costs of both technical devices and assisting personnel. CRRT was performed as continuous veno-venous hemodiafiltration (CVVHDF) (24 hr daily); dialysis and ICU nurses shared surveillance. Only dialysis nurses performed IHDF (as acetate-free biofiltration, 4 hr daily) in the ICU.
  
  
  RESULTS
  The daily cost of CRRT was Euro 276.70; of which 79% was for devices and 21% was for human resources. Nurse surveillance required 141 min per day, ICU nurses supplied 55% (77 min) and dialysis nurses 45% (64 min). On average, CRRT surveillance required less than 1 min/nurse/hr for both dialysis and ICU nurses. The daily cost of 4-hr IHDF sessions of was Euro 247.83, of which 44% was for technical devices and 56% was for human resources.
  
  
  CONCLUSIONS
  The cooperation between dialysis and ICUs improved the use of human resources and allowed us to supply CRRT to all critically ill patients with acute renal failure. The expenditure for CRRT was 12% higher than that for IHDF, due to the cost of technical devices.
authors.affiliation: Nephrology and Dialysis Unit, Renal Stone Centre, Mauriziano Umberto I Hospital, Turin, Italy. covitale@libero.it
authors.forename: Corrado
authors.initials: C
authors.lastname: Vitale
authors.forename: Cristiana
authors.initials: C
authors.lastname: Bagnis
authors.forename: Martino
authors.initials: M
authors.lastname: Marangella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Belloni
authors.forename: Mario
authors.initials: M
authors.lastname: Lupo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spina
authors.forename: Piervincenzo
authors.initials: P
authors.lastname: Bondonio
authors.forename: Adriano
authors.initials: A
authors.lastname: Ramello
mesh_terms: D058186:Acute Kidney Injury / Q000191:economics* / Q000628:therapy; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics / Q000379:methods; D005260:Female; D006282:Health Personnel / Q000191:economics; D017583:Hemodiafiltration / Q000191:economics / Q000379:methods; D006440:Hemofiltration / Q000191:economics / Q000379:methods; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D007558:Italy; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000191:economics* / Q000379:methods*; D012189:Retrospective Studies