Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital in Siriraj Hospital, Thailand

Background Hypothermia is a relatively common complication in patients receiving continuous renal replacement therapy (CRRT). However, few studies have reported the factors associated with hypothermia. Methods A retrospective cohort study was performed in five intensive care units (ICUs) to evaluate...

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Main Authors: Thonnarat Pornsirirat, Nualnapa Kasemvilawan, Patcharavalia Pattanacharoenwong, Saisunee Arpibanwana, Hatairat Kondon, Thummaporn Naorungroj
Format: Article
Language:English
Published: Korean Society of Critical Care Medicine 2024-08-01
Series:Acute and Critical Care
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Online Access:http://www.accjournal.org/upload/pdf/acc-2024-00038.pdf
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author Thonnarat Pornsirirat
Nualnapa Kasemvilawan
Patcharavalia Pattanacharoenwong
Saisunee Arpibanwana
Hatairat Kondon
Thummaporn Naorungroj
author_facet Thonnarat Pornsirirat
Nualnapa Kasemvilawan
Patcharavalia Pattanacharoenwong
Saisunee Arpibanwana
Hatairat Kondon
Thummaporn Naorungroj
author_sort Thonnarat Pornsirirat
collection DOAJ
description Background Hypothermia is a relatively common complication in patients receiving continuous renal replacement therapy (CRRT). However, few studies have reported the factors associated with hypothermia. Methods A retrospective cohort study was performed in five intensive care units (ICUs) to evaluate the incidence of hypothermia and the predictive factors for developing hypothermia during CRRT, with hypothermia defined as a time-weighted average temperature <36 °C. Results From January 2020 to December 2021, 300 patients were enrolled. Hypothermia developed in 23.7% of them within the first 24 hours after CRRT initiation. Compared to non-hypothermic patients, hypothermic patients were older and had lower body weight, more frequent acidemia, and higher ICU and 30-day mortality rates. In the multivariate analysis, age >70 years (odds ratio [OR], 2.59; 95% CI, 1.38–4.98; P=0.004), higher positive fluid balance on the day before CRRT (OR, 1.11; 95% CI, 1.02–1.22; P=0.02), and CRRT dose (OR, 1.003; 95% CI, 1.00–1.01; P=0.04) were significantly associated with hypothermia. Conversely, a higher body weight was independently associated with mitigated risk of hypothermia (OR, 0.89; 95% CI, 0.81–0.97; P=0.01). Moreover, a higher coefficient of variance of temperature was associated with greater ICU mortality (OR, 1.41; 95% CI, 1.13–1.78; P=0.003). Conclusion Hypothermia during CRRT is a relatively common occurrence, and factors associated with hypothermia onset in the first 24 hours include older age, lower body weight, higher positive fluid balance on the day before CRRT, and higher CRRT dose. Greater temperature variability was associated with increased ICU mortality.
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spelling doaj-art-faedfbd627d2486db3da50f2b056a9ee2024-11-18T23:51:10ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602024-08-0139337938910.4266/acc.2024.000381541Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital in Siriraj Hospital, ThailandThonnarat Pornsirirat0Nualnapa Kasemvilawan1Patcharavalia Pattanacharoenwong2Saisunee Arpibanwana3Hatairat Kondon4Thummaporn Naorungroj5 Division of Intensive Care, Department of Nursing, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Division of Intensive Care, Department of Nursing, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Division of Intensive Care, Department of Nursing, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Division of Intensive Care, Department of Nursing, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Division of Intensive Care, Department of Nursing, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Division of Intensive Care, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandBackground Hypothermia is a relatively common complication in patients receiving continuous renal replacement therapy (CRRT). However, few studies have reported the factors associated with hypothermia. Methods A retrospective cohort study was performed in five intensive care units (ICUs) to evaluate the incidence of hypothermia and the predictive factors for developing hypothermia during CRRT, with hypothermia defined as a time-weighted average temperature <36 °C. Results From January 2020 to December 2021, 300 patients were enrolled. Hypothermia developed in 23.7% of them within the first 24 hours after CRRT initiation. Compared to non-hypothermic patients, hypothermic patients were older and had lower body weight, more frequent acidemia, and higher ICU and 30-day mortality rates. In the multivariate analysis, age >70 years (odds ratio [OR], 2.59; 95% CI, 1.38–4.98; P=0.004), higher positive fluid balance on the day before CRRT (OR, 1.11; 95% CI, 1.02–1.22; P=0.02), and CRRT dose (OR, 1.003; 95% CI, 1.00–1.01; P=0.04) were significantly associated with hypothermia. Conversely, a higher body weight was independently associated with mitigated risk of hypothermia (OR, 0.89; 95% CI, 0.81–0.97; P=0.01). Moreover, a higher coefficient of variance of temperature was associated with greater ICU mortality (OR, 1.41; 95% CI, 1.13–1.78; P=0.003). Conclusion Hypothermia during CRRT is a relatively common occurrence, and factors associated with hypothermia onset in the first 24 hours include older age, lower body weight, higher positive fluid balance on the day before CRRT, and higher CRRT dose. Greater temperature variability was associated with increased ICU mortality.http://www.accjournal.org/upload/pdf/acc-2024-00038.pdfacute kidney injurycontinuous renal replacement therapyhypothermiamortality
spellingShingle Thonnarat Pornsirirat
Nualnapa Kasemvilawan
Patcharavalia Pattanacharoenwong
Saisunee Arpibanwana
Hatairat Kondon
Thummaporn Naorungroj
Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital in Siriraj Hospital, Thailand
Acute and Critical Care
acute kidney injury
continuous renal replacement therapy
hypothermia
mortality
title Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital in Siriraj Hospital, Thailand
title_full Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital in Siriraj Hospital, Thailand
title_fullStr Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital in Siriraj Hospital, Thailand
title_full_unstemmed Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital in Siriraj Hospital, Thailand
title_short Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital in Siriraj Hospital, Thailand
title_sort incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in siriraj hospital in siriraj hospital thailand
topic acute kidney injury
continuous renal replacement therapy
hypothermia
mortality
url http://www.accjournal.org/upload/pdf/acc-2024-00038.pdf
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