Thermic Control in PCRRT Theresa A. Mottes RN Research & Dialysis Nurse C. S. Mott Childrens Hospital University of Michigan

Sources of Heat Loss b Circuit heat loss large circuit volumelarge circuit volume blood flow rate dependentblood flow rate dependent dialysate rate dependentdialysate rate dependent

Sources of Heat Loss b Patient Heat Loss Large Hemofiltration circuit volumes relative to the patient sizeLarge Hemofiltration circuit volumes relative to the patient size External influencesExternal influences

Techniques for Thermic Control b Patient Warming Techniques Over-the-bed WarmerOver-the-bed Warmer –infants Warming BlanketWarming Blanket –older children Increase Room TemperatureIncrease Room Temperature

Techniques for Thermic Control b Circuit Warming Devices Blood WarmerBlood Warmer –Placed on the return line closest to the access Dialysate/Replacement Fluid WarmerDialysate/Replacement Fluid Warmer –Spectratherm –will be less effective if using Pre-filter Replacement Fluid

COBE Spectra THERM Blood/Fluid Warmer Temp (C 0 ) Flow Rates/hr 20 cm

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