Leblanc M, Sakai K, Wright EJ, Kozlowski L, Paganini EP
Incidence of hypothermia during continuous renal replacement therapy
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Nov) 6:545 1995

This study demonstrates the development of hypothermia in relation to CRRT procedures. Hypothermia developed in 35 of 72 ICU patients treated with CRRT in the ICU. It was commonly seen 4 days after therapy and lasted 2.6 ñ 1.8 days. It was more apparent during veno-venous procedures.

Comment: Hypothermia during CRRT has been recognized previously but the study demonstrates the frequency by different CRRT techniques. It is not clear whether the dialysate solutions were routinely heated in the CAVHD/CVVHD techniques as room temperature dialysate would contribute to core temperature reduction. Potential beneficial effect of hypothermia could be decreased energy expended. (Mehta)

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Am Soc Nephrol
Other extracorporeal therapies : Continous therapies


A majority of the patients I have helped treat (primarily CVVHDF) have developed hypothermia within 1-2 hours of initiating therapy. We had attempted pre-heating the fluid bags with a warming blanket, but the radiant heat loss to the room was too great to be of any real value. Radiant warmers are impractical in adult patients. The "Bear Hugger" devices have potential. My experience has been most favorable when a high capacity fluid warmer (s) are employed. At the risk of sounding like a sales rep, the "Hot-Line" warmers made by Level-1 have really done the job. The devices we use can deliver 5 liters/hr at body temp. The systems are set up to allow selective heating of the "pre-filter replacement" AND the dialysate fluid intake to the filter. This also permits us to modify the overall amount of heated fluid delivered to the system based on the patient tempeature. This flexability also permits using the non-heated fluid as an internal cooling system for hyperthermic patients.
Jeff McKinney, RN, CCRN (jjmrn@erols.com)
Mt. Airy, MD USA-Wednesday, May 28, 1997 at 00:25:24 (PDT)