Decreased CRRT Filter Lifespan in COVID-19 ICU Patients

Article Article scientifique Article Decreased CRRT Filter Lifespan in COVID-19 ICU Patients eng 2021 author Legouis David 883952 author Montalbano Maria F author Siegenthaler Nils 89602 author Thieffry Camille author Assouline Benjamin 595385 author Marti Pierre-Emmanuel 601637 author Sgardello Sebastian D author Andreetta Claudio Pietro Eliseo 76539 author Binvignat Céline author Pugin Jérôme 69624 author Heidegger Claudia Paula 0000-0002-5107-8217 843006 author Sangla Frédéric 910074 10.3390/jcm10091873 33925999 2077-0383 Background: Increased thromboembolic events and an increased need for continuous renal replacement therapy (CRRT) have been frequently reported in COVID-19 patients. Our aim was to investigate CRRT filter lifespan in intensive care unit (ICU) COVID-19 patients. Methods: We compared CRRT adjusted circuit lifespan in COVID-19 patients admitted for SARS-CoV-2 infection to a control group of patients admitted for septic shock of pulmonary origin other than COVID-19. Both groups underwent at least one session of CRRT for AKI. Results: Twenty-six patients (13 in each group) were included. We analysed 117 CRRT circuits (80 in the COVID-19 group and 37 in the control group). The adjusted filter lifespan was shorter in the COVID-19 group (17 vs. 39 h, p < 0.001). This trend persisted after adjustment for confounding factors (-14 h, p = 0.037). Before CRRT circuit clotting, the COVID-19 group had a more procoagulant profile despite higher heparin infusion rates. Furthermore, we reported a decreased relation between activated partial thromboplastin time (aPTT) and cumulative heparin dose in COVID-19 patients when compared to historical data of 23,058 patients, suggesting a heparin resistance. Conclusion: COVID-19 patients displayed a shorter CRRT filter lifespan that could be related to a procoagulant profile and heparin resistance. COVID-19 Continuous renal replacement therapy Filter lifespan ICU Coagulation Heparin Dewey 612 Dewey 617 134 Département de physiologie cellulaire et métabolisme 21C 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 321 Groupe Pugin Jérôme (Soins intensifs) 587 Journal of Clinical Medicine 10 9 949dbeeb-ca4b-4d2e-aa31-eb4081f4bc41 Article (Published version) Public jcm-10-01873.pdf 832725 application/pdf CC BY openAccess Faculté de médecine / Section de médecine fondamentale / Département de physiologie cellulaire et métabolisme Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Decreased CRRT Filter Lifespan in COVID-19 ICU Patients	Journal of Clinical Medicine			2021	203	290

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Andreetta, Claudio Pietro Eliseo