Introductory Chapter: Principles and Methods of Acute Therapies

Karkar, Ayman

doi:10.5772/intechopen.82503

Cited by 1 publication

(1 citation statement)

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“…The success of CRRT depends on the prescribed and achieved doses, which are a function of fluid replacement and/or dialysate administration rates, treatment duration, type of dialyzer and method, and dose of anticoagulation. Moreover, delivery and performance of CRRT require a well-established protocol (e.g., indications for initiation/ cessation, catheter management) and well-trained medical and nursing staff [6].…”

Section: Prescriptionmentioning

confidence: 99%

Prescription of CRRT: a pathway to optimize therapy

Karkar

Ronco²

2020

Ann. Intensive Care

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113

102

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Severe acute kidney injury (AKI), especially when caused or accompanied by sepsis, is associated with prolonged hospitalization, progression to chronic kidney disease (CKD), financial burden, and high mortality rate. Continuous renal replacement therapy (CRRT) is a predominant form of renal replacement therapy (RRT) in the intensive care unit (ICU) due to its accurate volume control, steady acid-base and electrolyte correction, and achievement of hemodynamic stability. This manuscript reviews the different aspects of CRRT prescription in critically ill patients with severe AKI, sepsis, and multiorgan failure in ICU. These include the choice of CRRT versus Intermittent and extended hemodialysis (HD), life of the filter/dialyzer including assessment of filtration fraction, anticoagulation including regional citrate anticoagulation (RCA), prescribed versus delivered CRRT dose, vascular access management, timing of initiation and termination of CRRT, and prescription in AKI/sepsis including adsorptive methods of removing endotoxins and cytokines.

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Section: Prescriptionmentioning

confidence: 99%