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Ann Intensive Care. 2015 Dec;5(1):58. doi: 10.1186/s13613-015-0093-5. Epub 2015 Dec 30.

Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

Author information

1
Réanimation polyvalente, CH Melun, 77000, Melun, France. christophe.vinsonneau@ch-melun.fr.
2
CHU Nantes, Nantes, France. emma.allainlaunay@chu-nantes.fr.
3
CHU Tenon, 75020, Paris, France. clarisse.blayau@tnn.aphp.fr.
4
CHU Saint-Etienne, 42055, Saint-Etienne, France. michael.darmon@chu-st-etienne.fr.
5
CHU Caen, 14033, Caen, France. ducheyron-d@chu-caen.fr.
6
CHU Rennes, 35000, Rennes, France. theophile.gaillot@chu-rennes.fr.
7
Intensive Care Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. patrick.honore@uzbrussel.be.
8
Réanimation pédiatrique spécialisée, CHU Lyon, 69677, Bron, France. etienne.javouhey@chu-lyon.fr.
9
CHRU Strasbourg, Strasbourg, France. thierry.krummel@chru-strasbourg.fr.
10
CHRU Lille, Lille, France. annie.lahoche@chru-lille.fr.
11
CHU Nancy, Nancy, France. s.letacon@chu-nancy.fr.
12
CHU Saint-Louis Lariboisière, Paris, France. matthieu.legrand@sls.aphp.fr.
13
Réanimation polyvalente, CH Melun, 77000, Melun, France. mn.monchi@gmail.com.
14
CHU Tenon, 75020, Paris, France. christophe.ridel@gmail.com.
15
CHU Poitiers, Poitiers, France. rene.robert@chu-poitiers.fr.
16
CHU Mondor, 94000, Créteil, France. frederique.schortgen@hmn.aphp.fr.
17
CHU Clermont-Ferrand, Clermont-Ferrand, France. bsouweine@chu-clermontferrand.fr.
18
CHU Necker, 75000, Paris, France. patrick.vaillant@nck.aphp.fr.
19
CHU Marseille, Marseille, France. lionel.velly@ap-hm.fr.
20
CHU Bicêtre, 94, Le Kremlin Bicêtre, France. david.osman@bct.aphp.fr.
21
Réanimation polyvalente, CH Melun, 77000, Melun, France. vong.lvp@free.fr.

Abstract

Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice.

KEYWORDS:

Anticoagulation; Citrate; Continuous renal replacement therapy; Dialysis dose; Hemodialysis; Recommendations; Renal replacement therapy

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