Decreased CRRT Filter Lifespan in COVID-19 ICU Patients

Legouis, David; Montalbano, Maria F; Siegenthaler, Nils; Thieffry, Camille; Assouline, Benjamin; Marti, Pierre-Emmanuel; Sgardello, Sebastian D; Andreetta, Claudio Pietro Eliseo; Binvignat, Céline; Pugin, Jérôme; Heidegger, Claudia Paula; Sangla, Frédéric

doi:10.3390/jcm10091873

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Title		Decreased CRRT Filter Lifespan in COVID-19 ICU Patients
Authors		Legouis, David Montalbano, Maria F Siegenthaler, Nils Thieffry, Camille Assouline, Benjamin Marti, Pierre-Emmanuel Sgardello, Sebastian D Andreetta, Claudio Pietro Eliseo Binvignat, Céline Pugin, Jérôme Heidegger, Claudia Paula Sangla, Frédéric show all authors [1 - 12]
Published in		Journal of clinical medicine. 2021, vol. 10, no. 9
Abstract		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.
Keywords		COVID-19 — Continuous renal replacement therapy — Filter lifespan — ICU — Coagulation — Heparin
Identifiers		DOI: 10.3390/jcm10091873 PMID: 33925999
Full text		Article (Published version) (813 Kb) - Free access
Structures		Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Section de médecine fondamentale / Département de physiologie cellulaire et métabolisme
Research group		Groupe Pugin Jérôme (Soins intensifs) (587)
Citation (ISO format)		LEGOUIS, David et al. Decreased CRRT Filter Lifespan in COVID-19 ICU Patients. In: Journal of Clinical Medicine, 2021, vol. 10, n° 9. doi: 10.3390/jcm10091873 https://archive-ouverte.unige.ch/unige:155822