Continuous venovenous renal replacement therapy in critically ill patients: A work load analysis.
OBJECTIVE
To evaluate the nursing workload related to two techniques of continuous renal replacement therapy.


METHODS
We analysed retrospectively the nursing work load caused directly by continuous renal replacement therapy in a cohort of patients admitted consecutively over 10 months. Two types of continuous renal replacement therapy have been compared: dialysis with regional citrate anticoagulation and haemodiafiltration with systemic heparin coagulation.


METHODS
Academic Hospital Intensive Care Unit.


METHODS
The nursing workload was defined by the time spent in the management of continuous renal replacement therapy, including preparation of the circuit and related biological controls.


RESULTS
60 patients underwent a total of 202 sessions of continuous renal replacement therapy. The nursing workload as expressed as % time of nursing care was similar (12.3 [9.4-18.8] vs 13.4 [11.7-17.0] %, for haemodiafiltration and dialysis respectively, P=0.06). However, the distribution of the nursing workload is different: the bigger proportion of care is circuit preparation in haemodiafiltration and biology control in dialysis.


CONCLUSIONS
Nursing time dedicated to continuous renal replacement therapy is similar whatever the renal replacement therapy technique. However, a longer duration of the filter and a better circuit predictability with dialysis and citrate anticoagulation are potential benefits for nursing workload.
Département d'anesthésie réanimation Arnaud de Villeneuve, Centre Hospitalier Régional et Universitaire, F-34295 Montpellier, France.
Marjorie
M
Houllé-Veyssière
Département d'anesthésie réanimation Arnaud de Villeneuve, Centre Hospitalier Régional et Universitaire, F-34295 Montpellier, France.
Audrey
A
Courtin
Département d'anesthésie réanimation Arnaud de Villeneuve, Centre Hospitalier Régional et Universitaire, F-34295 Montpellier, France.
Norddine
N
Zeroual
Département d'anesthésie réanimation Arnaud de Villeneuve, Centre Hospitalier Régional et Universitaire, F-34295 Montpellier, France.
Philippe
P
Gaudard
Département d'anesthésie réanimation Arnaud de Villeneuve, Centre Hospitalier Régional et Universitaire, F-34295 Montpellier, France. Electronic address: p-colson@chu-montpellier.fr.
Pascal H
PH
Colson
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D016638:Critical Illness / Q000534:rehabilitation*; D005260:Female; D017583:Hemodiafiltration / Q000451:nursing*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000379:methods* / Q000451:nursing*; D012189:Retrospective Studies; D013997:Time Factors; D016526:Workload / Q000592:standards*
D000925:Anticoagulants
Continuous renal replacement therapy; ICU nurse staff; Nursing activity; Nursing work load; Regional citrate anticoagulation