[Detection of risks for the safety of the patients in the implementation of continuous techniques of extracorporeal depuration (CTED)].
BACKGROUND
Continuous techniques of extracorporeal depuration (CTED) manage high volumes of fluid exchange and extensive control of its safety is required.


OBJECTIVE
To detect the risks of CTED and to determine its frequency per patient.


METHODS
An observational, retrospective study was performed. Inclusion criteria were patients admitted from January 2009 to December 2009, with CTED in the Polyvalent Intensive Care Unit (ICU) of the Hospital 12 de Octubre. We previously identified 10 risks that were detectable in the clinical records. We analyzed demographic and treatment variables. The quantitative variables were expressed as mean±SD and the qualitative ones as absolute and relative frequencies.


METHODS
SPSS 15.0(®).


RESULTS
A total of 54 patients (11.7%), with ages 59.78±14.8, 42 men (77.8%) were included. In 81.4%, the indication was acute kidney failure; 80.3% were treated with hemodiafiltration. Mean hours of CTED were 112.9±139.9 and the medium of 2 filters per patient (recommended intakes 0-31). Risk/patient rate was: 100% of patients without monitoring of the Mg and P, and 3.7% (n=2) urea; in 16 (29.6%), there was coagulation of the circuit prior to 24 hours and in 25 (46.3%) the blood could not be returned; in 14 (29.3%), written regime was always lacking on the order for treatment. The dose was not reflected on the patient's chart in 2 (3.7%); in 3 patients (5.6%) with coagulation disorder, anticoagulants were prescribed in the circuit. In 1 (1.9%) bleeding was observed and in 10 (18.5%) there was mild hypothermia (35-32°C).


CONCLUSIONS
A standardized monitoring of the Mg and P is required. The therapy should be prescribed in the medical treatment. The technique needs to be improved in order to prolong its duration and avoid blood losses.
Servicio de Medicina Intensiva, Hospital 12 de Octubre, Madrid, Spain. esteban.molanoa@salud.madrid.org
E
E
Molano Álvarez
A
A
Guirao Moya
M E
ME
Esteban Sánchez
P
P
Sanz Cruz
E
E
García Delgado
J Á
JÁ
Sánchez-Izquierdo Riera
D005260:Female; D006440:Hemofiltration / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D017751:Safety Management