Managing an Increase in Patient Census during Flu Season
According to the CDC and the Influenza Hospitalization Surveillance Network (FluSurv-NET), the “overall hospitalization rates (all ages) during 2017-2018 were the highest ever recorded,” with an estimated 710,000 hospitalizations related to the flu.1
Due to a spike in hospitalizations, particularly among people 65 years and older, the demand for renal replacement therapy peaks during flu season. This can create a real problem as hospitals struggle to treat more patients with limited availability of equipment, nurses, and supplies.
Some hospitals have overcome these challenges by using their NxStage System One for Prolonged Intermittent Renal Replacement Therapy (PIRRT). PIRRT is a gentle 6–12 hour therapy with similar hemodynamic, clearance, and survival outcomes to IHD and CRRT, along with greater flexibility in staffing and patient scheduling.2,3
PIRRT may help you in several ways:
Benefits to the Dialysis Unit:
If your ICU nurses are already familiar with the NxStage System One, patients normally on IHD can be placed on PIRRT and managed by the ICU to free the Dialysis staff to care for other non-acute patients.2
Benefits to the ICU:
Get more therapies from existing equipment.
- For patients who might otherwise be placed on CRRT during this peak period, PIRRT may be considered as a practical alternative for patients who can tolerate a 6–12 hour therapy.
- By transitioning patients off of CRRT to PIRRT, more than one patient can be treated using the same machine within a 24-hour period.
- The ICU can manage patients without relying on the availability of the Dialysis staff, who might also be dealing with an increased workload during flu season.
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- Garten R, et al. "Update: Influenza Activity in the United States During the 2017–18 Season and Composition of the 2018–19 Influenza Vaccine." Weekly, 2018. 67(22);634–642. Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a4.htm?s_cid=mm6722a4_w, Sep. 19, 2018.
- Concepcion LA, et al. ARF requiring dialysis: use of shift CVVHD vs. conventional dialysis. J Am Soc Nephrol. 2009; Suppl, F-P01557 (Abstract).
- Rodby R, Vijayan A. "Roundtable Discussion of Hybrid Renal Replacement Therapies." 2017, Revision A