Hemodynamic instability during connection to continuous kidney replacement therapy in critically ill pediatric patients

Standardizing Care in Pediatric Continuous Kidney Replacement Therapy—Can We Reach Consensus Without Adequate Evidence?

“…Ideally, a balancing metric exploring line-associated thrombi would shed more light into best practices given the recent reports of increased hypotensive episodes with internal jugular lines. 2 This study by Daverio and colleagues 1 may not capture actual practice patterns as only 1 person per PICU was surveyed, potentially introducing confirmation bias and availability heuristic. Indeed, this situation might explain the surprisingly short time reported between the decision to initiate and initiating CKRT (2 hours) as it is not quite clear how this data point was collected and may be biased by recall or optimism.…”

“…The caliber of lines used are much smaller than traditionally available in the US, emphasizing differences in access to right-sized equipment and disposables that challenge pediatric clinicians. Ideally, a balancing metric exploring line-associated thrombi would shed more light into best practices given the recent reports of increased hypotensive episodes with internal jugular lines …”