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Original Article
- Nephrology
- Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy in Siriraj Hospital, Thailand
- Thonnarat Pornsirirat, Nualnapa Kasemvilawan, Patcharavalia Pattanacharoenwong, Saisunee Arpibanwana, Hatairat Kondon, Thummaporn Naorungroj
- Acute Crit Care. 2024;39(3):379-389. Published online August 12, 2024
- DOI: https://doi.org/10.4266/acc.2024.00038
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- 5 Web of Science
- 5 Crossref
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Abstract
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Supplementary Material - 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.
Results
From January 2020 to December 2021, 300 patients were enrolled. Hypothermia developed in 23.7% of them within the first 24 hours after CRRT initiation. Compared to non-hypothermic patients, hypothermic patients were older and had lower body weight, more frequent acidemia, and higher ICU and 30-day mortality rates. In the multivariate analysis, age >70 years (odds ratio [OR], 2.59; 95% CI, 1.38–4.98; P=0.004), higher positive fluid balance on the day before CRRT (OR, 1.11; 95% CI, 1.02–1.22; P=0.02), and CRRT dose (OR, 1.003; 95% CI, 1.00–1.01; P=0.04) were significantly associated with hypothermia. Conversely, a higher body weight was independently associated with mitigated risk of hypothermia (OR, 0.89; 95% CI, 0.81–0.97; P=0.01). Moreover, a higher coefficient of variance of temperature was associated with greater ICU mortality (OR, 1.41; 95% CI, 1.13–1.78; P=0.003).
Conclusions
Hypothermia during CRRT is a relatively common occurrence, and factors associated with hypothermia onset in the first 24 hours include older age, lower body weight, higher positive fluid balance on the day before CRRT, and higher CRRT dose. Greater temperature variability was associated with increased ICU mortality. -
Citations
Citations to this article as recorded by
- Beyond the usual: A focus on infrequent complications of CRRT
Gonzalo Ramírez-Guerrero, Cristian Pedreros-Rosales, David Ballesteros, Mitchell Rosner, Claudio Ronco
Journal of Critical Care.2026; 91: 155270. CrossRef - Critical care nurses’ knowledge, attitude, and practice regarding hypothermia management during continuous renal replacement therapy: a cross-sectional study
Qingqing Sheng, Yufeng Tan, Xiaoqun Huang, Tingting He, Xiaoxia Li, Yao Huang, Liting Zeng, Xinning Wang, Mengmeng Xu, Shuqin Zhang, Lihua Chen
BMC Nursing.2026;[Epub] CrossRef - Development of a predictive score for hypothermia risk during continuous kidney replacement therapy in critically ill patients
Panisara Chummano, Thongkran Thongkam, Naphat Chansatchanali, Yutthasat Sonprasom, Wachiranun Sirikul, Konlawij Trongtrakul
Renal Failure.2026;[Epub] CrossRef - The prognostic value of skin temperature variability analysis in clinical settings: a systematic review of current evidence
Eubi Chan, Angelica Blotto, Ali R Mani
Physiological Measurement.2026; 47(8): 08TR01. CrossRef - Development and validation of a LASSO-based predictive model for inadvertent hypothermia in ICU patients
Xueting Wang, Yuxuan Chen, Lan Hua, Dongmei Wang, Xia Zhang, Lianhong Wang
Frontiers in Medicine.2025;[Epub] CrossRef
- Beyond the usual: A focus on infrequent complications of CRRT
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