ABSTRACTS from 16th International COnference on ... - CRRT Online

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
suggesting significant extracorporeal
clearance. The calculated SA was .98,
similar to the estimated SA of 1.
Conclusion: A calculated SA of .98
suggests peramivir was effectively
removed by CVVHDF. Based on
measured serum concentrations, a
peramivir loading dose of 6 mg followed
by 48 mg daily should provide
therapeutic levels.
61. A Retrospctive Review of
Transfusion Reduction and Cost
Savings Using the Circuit to
Circuit Exchange Technique in
Blood Primed CRRT Circuits.
Dawn M Eding RN, Richard M
Hackbarth MD, Alejandro Quiroga MD
Helen DeVos Children's Hospital
Background: The circuit-to-circuit
exchange technique for Continuous
Renal Replacement Therapy (CRRT)
was developed at Helen Devos
Children’s Hospital as a means to
minimize blood transfusions associated
with circuit priming in children less than
15 kg. This procedure involves blood
priming of the initial hemofiltration
circuit using donor red blood cells
(RBC). Subsequent circuits are then
primed with a transfer of the patient’s
own blood <strong>from</strong> the old circuit to a new
saline primed circuit thus avoiding
additional transfusion exposure.
Limiting blood exposure may benefit the
patient by reducing the risk of adverse
effects associated with transfusions. In
addition, the cost savings associated with
decreased blood utilization could impact
total health care delivery costs.
Methods: A three-year, retrospective
chart review of ten children less than 15
Kg requiring circuit blood priming while
receiving CRRT was conducted. Patient
age, weight, patient survival, days on
CRRT, number of circuits used (blood
prime and circuit exchange), circuit
priming volume, and volume of RBC
transfused during the CRRT course was
collected. The cost savings associated
with transfusion reduction was
calculated. Total per unit cost of RBC
transfusion (direct and indirect costs) is
estimated to be $761 US dollars as
determined by the activity-based cost
(ABC) model by Shander.
Results: Ten children were identified
during the study period. The mean
transfusion reduction associated with the
circuit exchange technique was
9.3ml/kg/day (± 9.6) of CRRT; with a
corresponding savings of $254 US
dollars (± 196) per CRRT day. No
statistically significant differences in
transfusion volume, days on CRRT, or
number of circuits used could be shown
between survivors and non-survivors,
possibly due to the small sample size.
Conclusions: The cost of blood and
concern’s over transfusion related
complications have generated increased
interest in ways to decrease blood usage.
The circuit exchange technique saved on
average two units of RBC transfusion
per CRRT course in these patients. This
is an effective way to reduce blood
transfusions thus potentially improving
patient outcomes and health care costs.
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