Thermic Control in PCRRT

1
Thermic Control in PCRRT

• Theresa A. Mottes RN
• Research Dialysis Nurse
• C. S. Mott Childrens Hospital
• University of Michigan

2
Sources of Heat Loss

• Circuit heat loss
• large circuit volume
• blood flow rate dependent
• dialysate rate dependent

3
Sources of Heat Loss

• Patient Heat Loss
• Large Hemofiltration circuit volumes relative to
  the patient size
• External influences

4
Techniques for Thermic Control

• Patient Warming Techniques
• Over-the-bed Warmer
• infants
• Warming Blanket
• older children
• Increase Room Temperature

5
Techniques for Thermic Control

• Circuit Warming Devices
• Blood Warmer
• Placed on the return line closest to the access
• Dialysate/Replacement Fluid Warmer
• Spectratherm
• will be less effective if using Pre-filter
  Replacement Fluid

6
COBE Spectra THERMBlood/Fluid Warmer
20 cm
Flow Rates/hr
Temp (C0)
7
Nursing Monitoring

• Monitor closely the patients temperature
• Observe for effectiveness of the warming
  techniques
• Note Patients not requiring warming
  interventions are most likely Febrile.