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Benefits of an early cooling phase in continuous renal replacement therapy for ICU patients.
Robert R., Méhaud J.-E., Timricht N., Goudet V., Mimoz O., Debaene B.
Annals of Intensive Care 2, 1 (2012) 40 - http://www.hal.inserm.fr/inserm-00748135
Benefits of an early cooling phase in continuous renal replacement therapy for ICU patients.
René Robert () 1, 2, 3, Jean-Eudes Méhaud1, 4, Najette Timricht1, Véronique Goudet1, Olivier Mimoz1, 5, Bertrand Debaene1
1 :  Service des urgences [Poitiers]
CHU Poitiers – Université de Poitiers
Poitiers, F86000
2 :  Service de Réanimation Médicale [Poitiers]
CHU Poitiers – Hôpital Jean Bernard
Poitiers Cedex, 86021
3 :  Ischémie - Reperfusion en transplantation d'organes
INSERM : U1082 – Université de Poitiers
Campus CHU Poitiers , 2 rue de la Milétrie 86021 Poitiers Cedex
4 :  Service d'anesthésie réanimation [Pau]
Centre Hospitalier de Pau
Pau, F64000
5 :  Pharmacologie des anti-infectieux
INSERM : ERI23 – Université de Poitiers
faculte des sciences 44, avenue du recteur pineau pole biologie sante medecine sud 86022 POITIERS CEDEX
ABSTRACT: BACKGROUND: Lowering the temperature setting in the heating device during continuous venovenous hemofiltration (CVVH) is an option. The purpose of this study was to determine the effects on body temperature and hemodynamic tolerance of two different temperature settings in the warming device in patients treated with CVVH. METHODS: Thirty patients (mean age: 66.5 years; mean SAPS 2: 55) were enrolled in a prospective crossover randomized study. After a baseline of 2 h at 38[DEGREE SIGN]C, the heating device was randomly set to 38[DEGREE SIGN]C (group A) and 36[DEGREE SIGN]C (group B) for 6 h. Then, the temperatures were switched to 36[DEGREE SIGN]C in group A and to 38[DEGREE SIGN]C in group B for another 6 h. Hemodynamic parameters and therapeutic interventions to control the hemodynamics were recorded. RESULTS: There was no significant change in body temperature in either group. During the first 6 h, group B patients showed significantly increased arterial pressure (p = 0.01) while the dosage of catecholamine was significantly decreased (p = 0.04). The number of patients who required fluid infusion or increase in catecholamine dosage was similar. During the second period of the study, hemodynamic parameters were unchanged in both groups. CONCLUSIONS: In patients undergoing CVVH, warming of the substitute over 36[DEGREE SIGN]C had no impact on body temperature. We showed that setting the fluid temperature at 36[DEGREE SIGN]C for a period of time early in the procedure is beneficial in terms of increased mean arterial pressure and decreased catecholamine infusion dosage.
Sciences du Vivant/Médecine humaine et pathologie/Physiologie

Articles dans des revues avec comité de lecture
Annals of Intensive Care (Ann Intensive Care)
Publisher BioMed Central
ISSN 2110-5820 

Renal replacement therapy – Hemofiltration – Hemodynamic – Rewarming device – Temperature
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