The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia-Systematic Review of the Literature.
hypothermia
renal replacement therapy
rewarming
Journal
International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455
Informations de publication
Date de publication:
13 09 2021
13 09 2021
Historique:
received:
02
08
2021
revised:
09
09
2021
accepted:
10
09
2021
entrez:
28
9
2021
pubmed:
29
9
2021
medline:
3
11
2021
Statut:
epublish
Résumé
Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia, below or equal to 32 °C. This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (identifier CRD42021232821). We searched Embase, Medline, and Cochrane databases using the keywords hypothermia, renal replacement therapy, hemodialysis, hemofiltration, hemodiafiltration, and their abbreviations. The search included only articles in English with no time limit, up until 30 June 2021. From the 795 revised articles, 18 studies including 21 patients, were selected for the final assessment and data extraction. The mean rate of rewarming calculated for all studies combined was 1.9 °C/h (95% CI 1.5-2.3) and did not differ between continuous (2.0 °C/h; 95% CI 0.9-3.0) and intermittent (1.9 °C/h; 95% CI 1.5-2.3) methods ( Based on the reviewed literature, it is currently not possible to provide high-quality recommendations for RRT use in specific groups of patients in accidental hypothermia. While RRT appears to be a viable rewarming strategy, the choice of rewarming method should always be determined by the specific clinical circumstances, the available resources, and the current resuscitation guidelines.
Sections du résumé
BACKGROUND
Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia, below or equal to 32 °C.
METHODS
This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (identifier CRD42021232821). We searched Embase, Medline, and Cochrane databases using the keywords hypothermia, renal replacement therapy, hemodialysis, hemofiltration, hemodiafiltration, and their abbreviations. The search included only articles in English with no time limit, up until 30 June 2021.
RESULTS
From the 795 revised articles, 18 studies including 21 patients, were selected for the final assessment and data extraction. The mean rate of rewarming calculated for all studies combined was 1.9 °C/h (95% CI 1.5-2.3) and did not differ between continuous (2.0 °C/h; 95% CI 0.9-3.0) and intermittent (1.9 °C/h; 95% CI 1.5-2.3) methods (
CONCLUSIONS
Based on the reviewed literature, it is currently not possible to provide high-quality recommendations for RRT use in specific groups of patients in accidental hypothermia. While RRT appears to be a viable rewarming strategy, the choice of rewarming method should always be determined by the specific clinical circumstances, the available resources, and the current resuscitation guidelines.
Identifiants
pubmed: 34574562
pii: ijerph18189638
doi: 10.3390/ijerph18189638
pmc: PMC8467292
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Références
J Anaesthesiol Clin Pharmacol. 2012 Jul;28(3):386-96
pubmed: 22869954
Ann Thorac Surg. 1989 Apr;47(4):608-11
pubmed: 2712635
Clin Toxicol (Phila). 2005;43(3):197-9
pubmed: 15902795
Resuscitation. 2015 Oct;95:100-47
pubmed: 26477701
Emerg Med Clin North Am. 2017 May;35(2):261-279
pubmed: 28411927
Acta Anaesthesiol Scand. 2020 Sep;64(8):1162-1166
pubmed: 32391571
CJEM. 2009 Mar;11(2):174-7
pubmed: 19272221
Resuscitation. 2011 Jun;82(6):790-1
pubmed: 21454007
Am J Kidney Dis. 2001 Aug;38(2):E8
pubmed: 11479182
J Trauma. 2008 Dec;65(6):1391-5
pubmed: 19077632
Intern Med. 2019 Sep 15;58(18):2743-2748
pubmed: 31178478
Artif Organs. 2010 Mar;34(3):237-9
pubmed: 20665964
Ann Cardiothorac Surg. 2019 Jan;8(1):137-142
pubmed: 30854323
Artif Organs. 2021 Jul 4;:
pubmed: 34219241
Scand J Trauma Resusc Emerg Med. 2019 Nov 26;27(1):105
pubmed: 31771645
J Emerg Med. 1988 Jul-Aug;6(4):277-80
pubmed: 3225430
J Trauma. 2007 Mar;62(3):775-6
pubmed: 17414366
Nephron. 1993;63(2):214-6
pubmed: 8450915
Ren Fail. 2012;34(6):784-8
pubmed: 22486196
Circulation. 2010 Nov 2;122(18 Suppl 3):S829-61
pubmed: 20956228
Scand J Trauma Resusc Emerg Med. 2016 Sep 15;24(1):111
pubmed: 27633781
BMJ Evid Based Med. 2018 Apr;23(2):60-63
pubmed: 29420178
Br Med J. 1965 May 8;1(5444):1217-9
pubmed: 14275019
Emerg Med J. 2007 Jul;24(7):511-2
pubmed: 17582054
Am Surg. 2020 Jan 1;86(1):73-75
pubmed: 32077419
Nephrol Dial Transplant. 2009 Mar;24(3):1054-6
pubmed: 19059934
Clin Nephrol. 1996 Jun;45(6):413-5
pubmed: 8793237
Asian J Surg. 2008 Jul;31(3):151-3
pubmed: 18658015
Neth J Med. 1996 Oct;49(4):160-3
pubmed: 8937085
Ann Thorac Surg. 2015 Oct;100(4):1353-8
pubmed: 26163357
Resuscitation. 2021 May;162:182-187
pubmed: 33675869
Crit Care Med. 2020 Dec;48(12):e1269-e1277
pubmed: 33105148
J Accid Emerg Med. 2000 Nov;17(6):422-4
pubmed: 11104248
Semin Dial. 2014 May-Jun;27(3):295-7
pubmed: 24118090