Evidence map›Paper›PMID 39741337›Full record

ArticleJournal of intensive care2024

Association of continuous renal replacement therapy downtime with fluid balance gap and clinical outcomes: a retrospective cohort analysis utilizing EHR and machine data.

Chloe Braun, Tomonori Takeuchi, Josh Lambert, Lucas Liu, Sarah Roberts, Stuart Carter, William Beaubien-Souligny, Ashita Tolwani, Javier A Neyra

Abstract read
In one paragraph

Article in Journal of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Chloe Braun *The University of Alabama at Birmingham, Birmingham, AL, USA. cgmeyer@uabmc.edu.ORCID http://orcid.org/0009-0009-5271-5669
Tomonori Takeuchi *The University of Alabama at Birmingham, Birmingham, AL, USA.
Josh LambertUniversity of Cincinnati, Cincinnati, OH, USA.
Lucas LiuPublic Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Sarah RobertsThe University of Alabama at Birmingham, Birmingham, AL, USA.
Stuart CarterThe University of Alabama at Birmingham, Birmingham, AL, USA.
William Beaubien-SoulignyCentre Hospitalier de L'Universite de Montreal, Montreal, QC, Canada.
Ashita TolwaniThe University of Alabama at Birmingham, Birmingham, AL, USA.
Javier A NeyraThe University of Alabama at Birmingham, Birmingham, AL, USA.

Funding

UAB-UCSD O'Brien Center for Acute Kidney Injury ResearchU54DK137307 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI ANUPAM AGARWAL · 2023 to 2026
$4.4M
Artificial Intelligence to Predict Outcomes in Patients with Acute Kidney Injury on Continuous Renal Replacement TherapyR01DK133539 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Girish Nitin Nadkarni, Javier A. Neyra · 2023 to 2026
$2.6M
The Relation of Soluble Klotho with Cardiovascular Disease, Chronic Kidney Disease Progression, and Blood Pressure in the Systolic Blood Pressure Intervention TrialR01DK128208 · NIDDK · TUFTS MEDICAL CENTER · PI DREW, DAVID ALAN, NEYRA, JAVIER A. · 2021 to 2025
$1.6M
NIDDK NIH HHS R01 DK128208NIDDK NIH HHS R01 DK133539NIDDK NIH HHS R01DK133539NIDDK NIH HHS U54 DK137307
6 · The paper itself

Abstract

backgroundFluid balance gap (FBgap-prescribed vs. achieved) is associated with hospital mortality. Downtime is an important quality indicator for the delivery of continuous renal replacement therapy (CRRT). We examined the association of CRRT downtime with FBgap and clinical outcomes including mortality.

methodsThis is a retrospective cohort study of critically ill adults receiving CRRT utilizing both electronic health records (EHR) and CRRT machine data. FBgap was calculated as achieved minus prescribed fluid balance. Downtime, or percent treatment time loss (%TTL), was defined as CRRT downtime in relation to the total CRRT time. Data collection stopped upon transition to intermittent hemodialysis when applicable. Linear and logistic regression models were used to analyze the association of %TTL with FBgap and hospital mortality, respectively. Covariates included demographics, Sequential Organ Failure Assessment (SOFA) score at CRRT initiation, use of organ support devices, and the interaction between %TTL and machine alarms.

resultsWe included 3630 CRRT patient-days from 500 patients with a median age of 59.5 years (IQR 50-67). Patients had a median SOFA score at CRRT initiation of 13 (IQR 10-16). Median %TTL was 8.1% (IQR 4.3-12.5) and median FBgap was 17.4 mL/kg/day (IQR 8.2-30.4). In adjusted models, there was a significant positive relationship between FBgap and %TTL only in the subgroup with higher alarm frequency (6 + alarms per CRRT-day) (β = 0.87 per 1% increase, 95%CI 0.48-1.26). No association was found in the subgroups with lower alarm frequency (0-2 and 3-5 alarms). There was no statistical evidence for an association between %TTL and hospital mortality in the adjusted model with the interaction term of alarm frequency.

conclusionsIn critically ill adult patients undergoing CRRT, %TTL was associated with FBgap only in the subgroup with higher alarm frequency, but not in the other subgroups with lower alarms. No association between %TTL and mortality was observed. More frequent alarms, possibly indicating unexpected downtime, may suggest compromised CRRT delivery and could negatively impact FBgap.

Indexed as

AKICRRTDowntimeFluid managementMortality

Identifiers

PMID39741337
PMCPMC11686856

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.