Skip to main content
. 2021 Sep 14;2021(9):CD013330. doi: 10.1002/14651858.CD013330.pub2

van der Voort 2005.

Study characteristics
Methods

  • Publication type: full article

  • Study design: cross‐over RCT

  • Follow‐up period: not reported

  • Duration of study: not reported

  • This study included two separate trials

    1. pre‐dilution versus post‐dilution

    2. Nadroparin infused by prefilter versus heparin infused by prefilter and protamine infused by post filter 
Participants

  • Country: Netherlands

  • Setting: single centre

  • ICU: yes

  • Number (randomised/analysed): study 1 (20/16); study 2 (20/15)

  • Median age, IQR (years): study 1 (75, 66 to 77); study 2 (68, 60 to 77)

  • Sex (M/F): study 1 (11/9); study 2 (9/11)

  • Median severity, IQR (APACHE 2): study 1 (27, 22 to 37); study 2 (31, 23 to 37)

  • Cause of AKI (number)

    • Study 1: sepsis (6); surgical (4); other (10)

    • Study 2: sepsis (7); surgical (2); other (11)

  • Inclusion criteria: mechanically ventilated, in ICU with AKI who had not been treated with CVVH or HD before

  • Exclusion criteria: in need of a specific CVVH mode, for instance, because of active bleeding; with planned surgery within 96 hours
Interventions

  • Treatment group

    • Study 1: one filter run in pre‐dilution CVVH

    • Study 2: one filter run with systemic nadroparin (475 IU/hour by continuous infusion prefilter)

  • Control group

    • Study 1: one filter run in post‐dilution CVVH

    • Study 2: one filter run with heparin (prefilter) and protamine (post‐filter)
Outcomes Study 1

  • Circuit lifespan

  • Costs of 1 week of CVVH in euros


Study 2

  • Circuit lifespan
Notes

  • Funding sources: unclear

  • We could not extract data from the first period (before crossing over)
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Insufficient information to permit judgement
Allocation concealment (selection bias) Unclear risk Insufficient information to permit judgement
Blinding of participants and personnel (performance bias)
All outcomes High risk Blinding was not feasible due to the nature of the intervention
Blinding of outcome assessment (detection bias)
All outcomes Low risk Outcomes were objective by nature
Incomplete outcome data (attrition bias)
All outcomes Low risk There were no drop‐outs
Selective reporting (reporting bias) Unclear risk Insufficient information to permit judgement
Other bias: baseline imbalance Unclear risk Cross‐over trial; we could not assess baseline imbalance
Other bias: co‐interventions Low risk Standardised protocol in terms of dialysis machine, ultrafiltration rate, blood flow, filter, anticoagulation, substitution fluid, and catheter was used,