Critical Illness Clinical Trial
Official title:
Renal Replacement Anticoagulant Management
Observational comparative effectiveness study of individual patient data using interrupted time series analysis techniques of linked data sources to establish clinical and health economic effects of moving from systemic heparin anticoagulation to regional citrate anticoagulation during continuous renal replacement therapy (CRRT) for patients treated on non-specialist Intensive Care Units (ICUs) in England and Wales.
RRAM is an observational comparative effectiveness and cost-effectiveness study of individual
patient data using interrupted time series analysis techniques and linked data sources. This
study will use existing high quality clinical data collected for the Case Mix programme (CMP)
- the national clinical audit for adult critical care - linked with Hospital Episodes
Statistics, Office for National Statistics, and UK Renal Registry national data sets to
establish the clinical and health economic effects of moving from systemic heparin
anticoagulation (SHA) to regional citrate anticoagulation (RCA) during CRRT for patients
treated on non-specialist ICUs in England and Wales. This will include data from
approximately 85,000 patients treated with CRRT between 1 April 2009 and 31 March 2017 in 184
English non-specialist intensive care units within the ICNARC CMP.
Specific objectives of the RRAM are to:
1. Investigate the short-term benefits, risks, and costs of citrate anticoagulation.
2. Provide information on the subsequent development of end-stage renal disease (ESRD).
3. Trial the efficient research techniques, that if successful could be used to track the
effects of any change in critical care practice occurring in ICUs in England and Wales
over a reasonably short time scale.
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