RRAM v1.0
Research type
Research Study
Full title
Renal Replacement Anticoagulant Management
IRAS ID
236515
Contact name
Peter Watkinson
Contact email
Sponsor organisation
Intensive Care National Audit & Research Centre (ICNARC)
Duration of Study in the UK
1 years, 3 months, 0 days
Research summary
It is common for patients in intensive care units (ICUs) to have acute kidney injury which prevents their kidneys from working properly. To avoid harm patients are treated with a machine that takes over the kidney functions until their own kidneys recover, this is called continuous renal replacement therapy (CRRT).
Traditionally heparin is added to the patients blood as it enters the CRRT machine to prevent it from clotting. This process is termed anticoagulation. Recently, citrate anticoagulation (an alternative to heparin) is being increasingly used in UK ICUs because it may be more controllable and possibly cheaper. However, both heparin and citrate are associated with different risks to the patient. Currently we do not know if one form of anticoagulation is better than the other as there have not been any good direct comparisons of the effects of CRRT using heparin and citrate.
Detailed electronic health records are available for all patients admitted to UK ICUs. We will use these records to identify adult patients treated in 184 non-specialist adult ICUs in England that needed at least one day of CRRT between 1st April 2009 and 31st March 2017. By surveying these ICUs to see which have swapped to citrate anticoagulation and when, we can then examine the effects of changing from heparin to citrate on patients’ well-being.
We will look at patients' survival, degree of sickness and how fast they recover. We can also use these to measure the cost of the two types of anticoagulation so we can assess the cost/benefit trade-off for both types of anticoagulation. We will be using medical records and will ensure patient confidentiality is safeguarded throughout by adhering to the strict rules governing this sort of research.
REC name
South Central - Oxford B Research Ethics Committee
REC reference
18/SC/0204
Date of REC Opinion
17 Apr 2018
REC opinion
Favourable Opinion