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Prescription of CRRT: a pathway to optimize therapy.
Annals of Intensive Care ( IF 8.1 ) Pub Date : 2020-03-06 , DOI: 10.1186/s13613-020-0648-y
Ayman Karkar 1, 2 , Claudio Ronco 1
Affiliation  

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.

中文翻译:

CRRT处方:优化治疗的途径。

严重的急性肾损伤(AKI),尤其是在引起败血症或伴有败血症时,与长期住院,进展为慢性肾脏疾病(CKD),经济负担和高死亡率有关。连续肾脏替代疗法(CRRT)是重症监护病房(ICU)中肾脏替代疗法(RRT)的主要形式,这是因为其精确的体积控制,稳定的酸碱和电解质校正以及实现血液动力学稳定性。该手稿回顾了重症监护病房中重症AKI,败血症和ICU多器官衰竭的CRRT处方的不同方面。其中包括选择CRRT相对于间歇性血液透析和延长血液透析(HD),过滤器/透析器的使用寿命(包括评估滤过率),抗凝(包括局部柠檬酸盐抗凝)(RCA),
更新日期:2020-04-20
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