Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital, Thailand
Issued Date
2024-08-01
Resource Type
ISSN
25866052
eISSN
25866060
Scopus ID
2-s2.0-85204360843
Journal Title
Acute and Critical Care
Volume
39
Issue
3
Start Page
379
End Page
389
Rights Holder(s)
SCOPUS
Bibliographic Citation
Acute and Critical Care Vol.39 No.3 (2024) , 379-389
Suggested Citation
Pornsirirat T., Kasemvilawan N., Pattanacharoenwong P., Arpibanwana S., Kondon H., Naorungroj T. Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital, Thailand. Acute and Critical Care Vol.39 No.3 (2024) , 379-389. 389. doi:10.4266/acc.2024.00038 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101386
Title
Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital, Thailand
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Corresponding Author(s)
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Abstract
Background: Hypothermia is a relatively common complication in patients receiving continuous renal replacement therapy (CRRT). However, few studies have reported the factors associated with hypothermia. Methods: A retrospective cohort study was performed in five intensive care units (ICUs) to evaluate the incidence of hypothermia and the predictive factors for developing hypothermia during CRRT, with hypothermia defined as a time-weighted average temperature <36 °C. Results: From January 2020 to December 2021, 300 patients were enrolled. Hypothermia developed in 23.7% of them within the first 24 hours after CRRT initiation. Compared to non-hypothermic patients, hypothermic patients were older and had lower body weight, more frequent acidemia, and higher ICU and 30-day mortality rates. In the multivariate analysis, age >70 years (odds ratio [OR], 2.59; 95% CI, 1.38–4.98; P=0.004), higher positive fluid balance on the day before CRRT (OR, 1.11; 95% CI, 1.02–1.22; P=0.02), and CRRT dose (OR, 1.003; 95% CI, 1.00–1.01; P=0.04) were significantly associated with hypothermia. Conversely, a higher body weight was independently associated with mitigated risk of hypothermia (OR, 0.89; 95% CI, 0.81–0.97; P=0.01). Moreover, a higher coefficient of variance of temperature was associated with greater ICU mortality (OR, 1.41; 95% CI, 1.13–1.78; P=0.003). Conclusions: Hypothermia during CRRT is a relatively common occurrence, and factors associated with hypothermia onset in the first 24 hours include older age, lower body weight, higher positive fluid balance on the day before CRRT, and higher CRRT dose. Greater temperature variability was associated with increased ICU mortality.