A case of hypothermia on CRRT.

Hemodial Int

Department of Medicine, Division of Nephrology, University of Missouri, Columbia, Missouri, USA.

Published: October 2017

A 64-year-old Asian man, with past medical history of hypertension, hypothyroidism, and hyperlipidemia, presented with 3 days history of fever associated with cough and worsening shortness of breath. Subsequent clinical course was complicated by acute lung injury leading to acute respiratory distress syndrome requiring positive pressure ventilation, septic shock requiring inotropic support, and acute kidney injury requiring continuous renal replacement therapy (CRRT). On day 3 of CRRT, the patient developed significant hypothermia (temporal temperature 27.5°C), which was successfully managed. Continuous renal replacement therapy was subsequently discontinued as renal function recovered and the patient was discharged home after a prolonged hospital stay. He currently remains off dialysis and is being followed as an outpatient for chronic kidney disease. In this article, we examine various aspects of pathophysiology and management of hypothermia on CRRT and review relevant literature in this field.

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http://dx.doi.org/10.1111/hdi.12601DOI Listing

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Article Synopsis
  • One significant risk of continuous renal replacement therapy (CRRT) is inadvertent hypothermia, which occurs when a patient's core temperature falls below the normal range due to heat loss during the process.
  • A study compared the effectiveness of the new TherMax warmer against an older warmer model in preventing hypothermia among 100 patients receiving CRRT in Swedish ICUs.
  • Results showed that 77% of patients using TherMax were free of hypothermia compared to just 30% in the control group, with the TherMax warmer also maintaining more accurate patient temperatures.
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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.

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Objective: To systematically review the risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients.

Methods: A combination of subject words + free words was used to search the relevant literature published in CNKI, Wanfang, VIP, CBM, PubMed, EMbase, Web of Science, Cochrane Library, Mediline and other databases. The search period was from the establishment of the databases to June 25, 2024.

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Continuous renal replacement therapy (CRRT) is a commonly used therapeutic modality in the pediatric intensive care unit (PICU) for the treatment of severe acute kidney injury, as well as for addressing metabolic abnormalities, fluid-electrolyte imbalances, and acid-base disorders. According to reports, therapeutic hypothermia treatment has demonstrated the ability to decrease cellular metabolism, oxygen consumption, formation of free radicals, cell death, and inflammatory signals. The study encompassed all individuals who underwent CRRT at both Manisa City Hospital and Manisa Celal Bayar University Hospital throughout the period from February 2021 to November 2022.

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[Analysis of the incidence and related factors of hypothermia in patients with continuous renal replacement therapy].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue

April 2023

Department of Critical Care Medicine, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Anhui Provincial Clinical Research Center for Critical Respiratory Disease, Wuhu 241000, Anhui, China. Corresponding author: Jiang Xiaogan, Email:

Objective: To investigate the incidence and risk factors of hypothermia in patients with acute renal injury (AKI) receiving continuous renal replacement therapy (CRRT), and to compare the effects of different heating methods on the incidence of hypothermia in patients with CRRT.

Methods: A prospective study was conducted. AKI patients with CRRT who were admitted to the department of critical care medicine of the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) from January 2020 to December 2022 were enrolled as the study subjects.

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