Association of net ultrafiltration intensity and clinical outcomes among critically ill patients receiving continuous renal replacement therapy: A systematic review, meta-analysis, and trial sequential analysis

IF 2.6 3区 医学 Q2 CRITICAL CARE MEDICINE Australian Critical Care Pub Date : 2025-01-30 DOI:10.1016/j.aucc.2024.101170
Lu Jin MBBS, Peiyun Li MM, Qing Xu MBBS, Fang Wang MD, Ling Zhang MD, PhD
{"title":"Association of net ultrafiltration intensity and clinical outcomes among critically ill patients receiving continuous renal replacement therapy: A systematic review, meta-analysis, and trial sequential analysis","authors":"Lu Jin MBBS,&nbsp;Peiyun Li MM,&nbsp;Qing Xu MBBS,&nbsp;Fang Wang MD,&nbsp;Ling Zhang MD, PhD","doi":"10.1016/j.aucc.2024.101170","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Net ultrafiltration (UF<sup>net)</sup> has been used in the fluid management of critically ill patients undergoing continuous renal replacement therapy for an extended duration. Despite its widespread application, the correlation between UF<sup>net</sup> intensity and clinical outcomes remains controversial.</div></div><div><h3>Methods</h3><div>Electronic databases (PubMed, Embase, Web of Science, and the Cochrane database) were searched from inception to November 30, 2023. All possible studies that examined the following outcomes were included: all-cause mortality, recovery of kidney function, and length of hospital stay.</div></div><div><h3>Results</h3><div>A total of 6209 patients from six cohort studies were included. There was no significant association observed between UF<sup>net</sup> intensity and either mortality (odds ratio [OR] = 0.90, 95% confidence interval [CI] = 0.68–1.21, p = 0.49, I<sup>2</sup> = 84%) or renal recovery (OR = 0.96, 95% CI = 0.57–1.61, p = 0.87, I<sup>2</sup> = 75%) among critically ill patients. However, a high intensity of UF<sup>net</sup> was associated with lower mortality in patients with acute kidney injury (AKI) (OR = 0.73, 95% CI = 0.59–0.90, p = 0.004, I<sup>2</sup> = 67%). Furthermore, the study revealed a noteworthy correlation between a high UF<sup>net</sup> intensity and a longer length of hospital stay (weighted mean difference = 3.34 d, 95% CI = 2.64–4.03, p<sup>2</sup> = 0%).</div></div><div><h3>Conclusions</h3><div>The association between UF<sup>net</sup> intensity and mortality or renal recovery in critically ill patients is insufficient. However, a high UF<sup>net</sup> intensity is associated with an increasing length of hospital stay among critically ill patients.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 3","pages":"Article 101170"},"PeriodicalIF":2.6000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Critical Care","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1036731424003217","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Net ultrafiltration (UFnet) has been used in the fluid management of critically ill patients undergoing continuous renal replacement therapy for an extended duration. Despite its widespread application, the correlation between UFnet intensity and clinical outcomes remains controversial.

Methods

Electronic databases (PubMed, Embase, Web of Science, and the Cochrane database) were searched from inception to November 30, 2023. All possible studies that examined the following outcomes were included: all-cause mortality, recovery of kidney function, and length of hospital stay.

Results

A total of 6209 patients from six cohort studies were included. There was no significant association observed between UFnet intensity and either mortality (odds ratio [OR] = 0.90, 95% confidence interval [CI] = 0.68–1.21, p = 0.49, I2 = 84%) or renal recovery (OR = 0.96, 95% CI = 0.57–1.61, p = 0.87, I2 = 75%) among critically ill patients. However, a high intensity of UFnet was associated with lower mortality in patients with acute kidney injury (AKI) (OR = 0.73, 95% CI = 0.59–0.90, p = 0.004, I2 = 67%). Furthermore, the study revealed a noteworthy correlation between a high UFnet intensity and a longer length of hospital stay (weighted mean difference = 3.34 d, 95% CI = 2.64–4.03, p2 = 0%).

Conclusions

The association between UFnet intensity and mortality or renal recovery in critically ill patients is insufficient. However, a high UFnet intensity is associated with an increasing length of hospital stay among critically ill patients.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Australian Critical Care
Australian Critical Care NURSING-NURSING
CiteScore
4.90
自引率
9.10%
发文量
148
审稿时长
>12 weeks
期刊介绍: Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.
期刊最新文献
Prevalence and variability in use of physical restraints in intensive care units: A systematic review and meta-analysis Effects of prophylactic non-invasive ventilation on weaning: A systematic review with meta-analysis Harnessing machine learning for predicting successful weaning from mechanical ventilation: A systematic review Multicentre prospective study to establish a risk prediction model on pressure injury in the neonatal intensive and intermediate care units Effects of compassion fatigue, structural empowerment, and psychological empowerment on the caring behaviours of intensive care unit nurses in China: A structural equation modelling analysis
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1