Extracorporeal circuit temperature gradient and hemodynamic instability during continuous renal replacement therapy: an observational study
Authors' conclusion
During CRRT, setting the circuit temperature below body temperature was associated with a reduced HIRRT risk, an effect potentially mediated through improvements in MAP and CO.
Study context
- Population
- Patients with stage 3 AKI receiving continuous renal replacement therapy (CRRT) for <24 h with continuous cardiac index monitoring1,012 observations
- Participants
- 42 patients
- Exposure
- ΔT° ≤0°C vs higher circuit-to-core temperature gradient
- Outcome
- HIRRT (MAP <65 mmHg requiring therapeutic intervention), mediated through CO and MAP
- Follow-up
- During (inclusion to day 7)
Methodological detailssingle-centre, exploratory mediation analysis
- Single-centre
- Exploratory mediation analysis
Main finding
As reported in the abstract
Probability of HIRRT with ΔT° ≤0°C (mediation analysis)
Total effect: decrease in probability of HIRRT
7%
95% CI 1%–14%
Indirect effect (ACME) through MAP (2%-7%)
5%
Indirect effect (ACME) through cardiac output (CO) (1%-5%)
4%
Observational data: associations, not effects.
Further findings
Hemodynamics and HIRRT risk (univariate analysis)
- Decreasing ΔT° associated with higher heart rate, CO and MAP, lower norepinephrine dose, and reduced HIRRT risk
- P < 0.01
Original publication
Extracorporeal circuit temperature gradient and hemodynamic instability during continuous renal replacement therapy: an observational study. Ann Intensive Care. Published 1 July 2026. doi:10.
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