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Continuous renal replacement therapy (CRRT) often causes significant heat loss in critically ill patients. Consequently, clinicians must implement effective CRRT warming strategies to prevent procedure-induced hypothermia. Specifically, a recent prospective study investigated temperature trends among patients using different warming approaches in routine practice. In fact, researchers followed eighty-nine adults for eight hours to compare active and passive warming methods.
The results showed that mean body temperature generally decreased over the study period. However, both active warming strategies maintained significantly higher temperatures than no warming at all. Furthermore, after adjusting for baseline covariates, the warming method remained a primary predictor of thermal stability. Moreover, the extracorporeal blood warming unit demonstrated the best results because this device provided the highest adjusted mean temperature throughout the observation. In contrast, the control group suffered a progressive decline in temperature during the eight-hour window.
Additionally, the data indicates that active warming improves thermal stability regardless of the patient's starting temperature. Because hypothermia can trigger cardiovascular and metabolic complications, these findings are vital for ICU protocols. Therefore, integrating active warming devices into standard care is necessary. Indeed, using extracorporeal units appears superior to relying on passive methods alone. Thus, healthcare providers should prioritize these active interventions to ensure patient safety.
Similarly, previous research highlights that hypothermia during dialysis is associated with increased mortality. For example, temperature variability in the ICU can lead to hemodynamic instability. As a result, maintaining normothermia is not just about comfort but also about survival. In addition, these findings support routine integration of devices. Finally, the evidence suggests that active methods provide the most reliable way to stabilize core temperatures.
Patients lose heat because their blood circulates through an extracorporeal circuit exposed to cooler room air. Consequently, this process leads to significant thermal energy loss unless active warming is applied.
Active strategies, such as using extracorporeal warming units, provide consistent heat to the blood. As a result, they maintain normothermia more effectively than passive blankets or no intervention, reducing the risk of hypothermia-related complications.
Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or establish a doctor-patient relationship. Always seek the advice of a qualified healthcare provider regarding any medical condition or treatment. Refer to the latest local and national guidelines for clinical practice.
References
Bulbul E et al. Body temperature trends during continuous renal replacement therapy according to different warming approaches: A prospective observational study. Int J Artif Organs. 2026 Apr 04. doi: 10.1177/03913988261429924. PMID: 41934217.
Pornsirirat T, et al. Incidence of hypothermia in critically ill patients receiving continuous renal replacement therapy. Acute Crit Care. 2024;39(3):379-389.
Bell M, et al. Cost-effectiveness of the TherMax blood warmer during continuous renal replacement therapy. PLOS One. 2022;17(2):e0263321.

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