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In-line filtration reduces severe complications and length of stay on pediatric intensive care unit: a prospective, randomized, controlled trial
- Source :
- Intensive Care Medicine
- Publication Year :
- 2012
- Publisher :
- Springer-Verlag, 2012.
-
Abstract
- Purpose Particulate contamination due to infusion therapy carries a potential health risk for intensive care patients. Methods This single-centre, prospective, randomized controlled trial assessed the effects of filtration of intravenous fluids on the reduction of complications in critically ill children admitted to a pediatric intensive care unit (PICU). A total of 807 subjects were randomly assigned to either a control (n = 406) or filter group (n = 401), with the latter receiving in-line filtration. The primary endpoint was reduction in the rate of overall complications, which included the occurrence of systemic inflammatory response syndrome (SIRS), sepsis, organ failure (circulation, lung, liver, kidney) and thrombosis. Secondary objectives were a reduction in the length of stay on the PICU and overall hospital stay. Duration of mechanical ventilation and mortality were also analyzed. Findings Analysis demonstrated a significant reduction in the overall complication rate (n = 166 [40.9 %] vs. n = 124 [30.9 %]; P = 0.003) for the filter group. In particular, the incidence of SIRS was significantly lower (n = 123 [30.3 %] vs. n = 90 [22.4 %]; P = 0.01). Moreover the length of stay on PICU (3.89 [95 % confidence interval 2.97−4.82] vs. 2.98 [2.33−3.64]; P = 0.025) and duration of mechanical ventilation (14.0 [5.6−22.4] vs. 11.0 [7.1−14.9] h; P = 0.028) were significantly reduced. Conclusion In-line filtration is able to avert severe complications in critically ill patients. The overall complication rate during the PICU stay among the filter group was significantly reduced. In-line filtration was effective in reducing the occurrence of SIRS. We therefore conclude that in-line filtration improves the safety of intensive care therapy and represents a preventive strategy that results in a significant reduction of the length of stay in the PICU and duration of mechanical ventilation (ClinicalTrials.gov number: NCT00209768). Electronic supplementary material The online version of this article (doi:10.1007/s00134-012-2539-7) contains supplementary material, which is available to authorized users.
- Subjects :
- Male
medicine.medical_specialty
Critical Illness
In-line filtration
Particle
Critical Care and Intensive Care Medicine
Intensive Care Units, Pediatric
law.invention
Randomized controlled trial
Infusion therapy
law
Intensive care
Anesthesiology
Germany
Medicine
SIRS
Humans
Prospective Studies
Intensive care medicine
Prospective cohort study
Child
Children
Infusion Pumps
Pediatric intensive care unit
Inflammation
business.industry
Length of Stay
In line filtration
Pediatric Original
Female
business
Complication
Drug Contamination
Filtration
Subjects
Details
- Language :
- English
- ISSN :
- 14321238 and 03424642
- Volume :
- 38
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Intensive Care Medicine
- Accession number :
- edsair.doi.dedup.....9aa2520b1a058cf79db79d9f63d36034