Intensity of Renal Replacement Therapy and Duration of Mechanical Ventilation: Secondary Analysis of the Acute Renal Failure Trial Network Study.

Intensity of Renal Replacement Therapy and Duration of Mechanical Ventilation: Secondary Analysis of the Acute Renal Failure Trial Network Study. Chest. 2020 May 26;: Authors: Sharma S, Kelly YP, Palevsky PM, Waikar SS Abstract BACKGROUND: Randomized clinical trials have failed to show benefit from increasing intensity of renal replacement therapy (RRT), but continue to be frequently utilized. In addition, intensive RRT is associated with an increase in adverse events potentially secondary to small solute losses, such as phosphate. We hypothesized that, compared to less intensive RRT, intensive RRT would lead to longer duration of mechanical ventilation. RESEARCH QUESTION: Does more-intensive renal replacement therapy in critically ill patients with AKI increase time to extubation from mechanical ventilation when compared with less-intensive therapy? STUDY DESIGN AND METHODS: The ATN study was a randomized multicenter trial of more-intensive (hemodialysis or sustained low-efficiency dialysis six times per week or continuous venovenous hemodiafiltration at 35 ml/kg per hour) versus less-intensive (hemodialysis or sustained low-efficiency dialysis three times per week or continuous venovenous hemodiafiltration at 20 ml/kg per hour) RRT in critically ill patients with AKI. Of 1124 patients, 907 who were supported by mechanical ventilation on study initiation were included in this cox-proportional hazards analysis. The pr...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research