None listed
Conditions
Brief summary
Both hypercapnic respiratory failure and acute kidney injury (AKI) are common problems in Intensive Care Units (ICUs). When either or both are severe, organ support in the form of non-invasive ventilation (NIV), mechanical ventilation (MV) and continuous renal replacement therapy (CRRT) are sometimes required. In some of these patients, extracorporeal carbon dioxide (CO2) removal (ECCO2R) may also be required. Although there has been detailed description of circuit pressures and filter life in CRRT, there is no published clinical data affecting the adequacy of treatment with ECCO2R and circuit haemodynamics and filter life when ECCO2R is combined with CRRT or used as standalone without CRRT. Our group have published a case series of patients where ECCO2R was used in conjunction with CRRT. The main complication noted in this study was circuit clotting within 72 hours of initiation of ECC02R. Circuit clotting can lead to poorer delivered treatment doses, requirement of red cell transfusion due to blood loss and increased resource requirement for re-commencement of therapy. It is unclear if the circuit haemodynamics and filter life, is impacted by the way ECCO2R is delivered i.e. ECCO2R in conjunction with CRRT compared to standalone ECCO2R or conventional CRRT. This research investigates the circuit haemodynamics and filter life and its clinical effects
Interventions
Extracorporeal carbon dioxide removal (ECCO2R) is an emerging therapy for managing hypercapnic respiratory failure in critically ill patients. It utilizes an extracorporeal blood circuit equipped with a membrane designed to remove CO2 from the bloodstream. The circuit incorporates multiple safety features, including continuous monitoring of circuit pressures, which are routinely recorded as part of standard clinical care.. This retrospective observational study aims to evaluate the performance o
Extracorporeal carbon dioxide removal (ECCO2R) is an emerging therapy for managing hypercapnic respiratory failure in critically ill patients. It utilizes an extracorporeal blood circuit equipped with a membrane designed to remove CO2 from the bloodstream. The circuit incorporates multiple safety features, including continuous monitoring of circuit pressures, which are routinely recorded as part of standard clinical care.. This retrospective observational study aims to evaluate the performance of ECCO2R circuits by analyzing filter pressure data. Specifically, it will assess the median duration of circuit functionality and its association with changes in key clinical parameters such as pH, PaCO2, duration of ECCO2R therapy, and hospital mortality. All data required for this study are routinely collected as part of standard clinical care. No additional procedures, interventions, or data collection will be required from participants. The study will utilize existing clinical records, including circuit pressure measurements and relevant laboratory and outcome data. As this study involves retrospective analysis of routinely collected clinical data, there is no direct involvement of patients beyond their standard care. The observation period will span the entire duration of ECCO2R and CRRT treatment and the patient’s hospital stay. We will study the circuit life of 'CRRT + ECCO2R' or standalone ECCO2R (case) and compare to standalone ECCO2R and conventional CRRT (controls) as to the duration of the circuit and their relationship to circuit pressure changes.
Sponsors
Peninsula Health, Frankston Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients who underwent CRRT, standalone ECCO2R or CRRT-ECCO2R with the PrisMax device where a treatment recording on PrisMax device could be linked back to a patient.
Exclusion criteria
CRRT /ECCO2R data not recorded on machine
Outcome results
None listed