title: Comparison of circuit patency and exchange rates between 2 different continuous renal replacement therapy machines.
abstract: BACKGROUND
  Continuous renal replacement therapy (CRRT) is an important tool in the care of critically ill patients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit (ICU) bedside nurse delivery model for CRRT while comparing circuit patency and circuit exchange rates in 2 Food and Drug Administration-approved CRRT devices. This article presents the data comparing circuit exchange rates for 2 different CRRT machines.
  
  
  METHODS
  A group of ICU nurses were selected to undergo expanded training in CRRT operation and empowered to deliver all aspects of CRRT. The ICU nurses then provided all aspects of CRRT on 2 Food and Drug Administration-approved CRRT devices for 6 months. Each device was used exclusively in the designated ICU for a 2-week run-in period followed by 3-month data collection period. The primary end point for the study was the differences in average number of filter exchanges per day during each CRRT event.
  
  
  RESULTS
  A total of 45 unique patients who underwent 64 separate CRRT treatment periods were included. Four CRRT events were excluded (see text for details). Twenty-eight CRRT events occurred in the NxStage System One arm (NxStage Medical, Lawrence, Mass) and 32 events in the Gambro Prismaflex arm (Gambro Renal Products, Boulder, Colo). Average (SD) filter exchanges per day was 0.443 (0.60) for the NxStage System One machine and 0.553 (0.65) for Gambro Prismaflex machine (P = .09).
  
  
  CONCLUSIONS
  There was no demonstrable difference in circuit patency as defined by the rate of filter exchanges per day of CRRT therapy.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, GA; Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA. Electronic address: amir.razavi@emoryhealthcare.org.
authors.forename: Seyed Amirhossein
authors.initials: SA
authors.lastname: Razavi
authors.affiliation: Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA; Department of Nursing, Emory University Hospital, Emory University School of Medicine, Atlanta, GA.
authors.forename: Mary D
authors.initials: MD
authors.lastname: Still
authors.affiliation: Department of Palliative Care, Piedmont Fayette Hospital, Fayetteville, GA.
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: White
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, GA; Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Buchman
authors.affiliation: Emory Center for Critical Care, Emory University School of Medicine, Atlanta, GA; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Connor
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy*; D000368:Aged; D064648:Critical Care Nursing / Q000193:education*; D016638:Critical Illness; D018592:Cross-Over Studies; D019544:Equipment Failure Analysis / Q000706:statistics & numerical data; D005260:Female; D005374:Filtration / Q000295:instrumentation* / Q000706:statistics & numerical data; D015312:Hemodialysis Solutions; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D058996:Quality Improvement; D017582:Renal Replacement Therapy / Q000295:instrumentation* / Q000379:methods / Q000401:mortality / Q000451:nursing
chemical_list: D015312:Hemodialysis Solutions
keywords: Circuit survival; Continuous renal replacement therapy; Filter exchange; Gambro Prismaflex machine; NxStage System One machine; Quality improvement