tailieunhanh - Báo cáo y học: "Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study. | Srisawat et al. Critical Care 2010 14 R46 http content 14 2 R46 c CRITICAL CARE RESEARCH Open Access Cost of acute renal replacement therapy in the intensive care unit results from The Beginning and Ending Supportive Therapy for the Kidney BEST Kidney Study 1 3 4 1 Nattachai Srisawat Loredo Lawsin 1 Shigehiko Uchino Rinaldo Bellomo John A Kellum the BEST Kidney Investigators Abstract Introduction Severe acute kidney injury AKI can be treated with either continuous renal replacement therapy CRRT or intermittent renal replacement therapy IRRT . Limited evidence from existing studies does not support an outcome advantage of one modality versus the other and most centers around the word use both modalities according to patient needs. However cost estimates involve multiple factors that may not be generalizable to other sites and to date only single-center cost studies have been performed. The aim of this study was to estimate the cost difference between CRRT and IRRT in the intensive care unit ICU . Methods We performed a post hoc analysis of a prospective observational study among 53 centers from 23 countries from September 2000 to December 2001. We estimated costs based on staffing as well as dialysate and replacement fluid anticoagulation and extracorporeal circuit. Results We found that the theoretic range of costs were from 3 day more with CRRT to day more with IRRT. The median difference in cost between CRRT and IRRT was IQR per day greater with CRRT . Costs also varied greatly by region. Reducing replacement fluid volumes in CRRT to 25 ml min approximately 25 ml kg hr would result in day mean savings. Conclusions Cost considerations with RRT are important and vary substantially among centers. We identified the relative impact of four cost domains nurse staffing fluid anticoagulation and extracorporeal circuit on overall cost differences and hospitals can look to these areas to reduce costs associated .