Haemodynamic impact of a slower pump speed at start of continuous renal replacement therapy in critically ill adults with acute kidney injury: A prospective before-and-after study

Abstract

Background and Objective: Patients are at risk of haemodynamic instability when starting continuous renal replacement therapy (CRRT). Methods: We compared data for 'routine-protocol' pump speed increases of 50 ml/min over 1-4 min with 'slower' increases of 20-50 ml/min over 3-10 min to achieve an operating blood flow of 200 ml/min. Results: We studied 21 routine and 20 slower CRRT starts. 'Routine protocol' starts reached the target pump speed more quickly than the slower CRRT start (p < 0.05). Heart rate was higher in the routine group compared to the slower group at baseline (p < 0.01) and remained so throughout. There were no significant changes in central venous pressure or mean arterial..