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Adv Chronic Kidney Dis. 2017 Jul;24(4):213-218. doi: 10.1053/j.ackd.2017.05.003.

Continuous Renal Replacement Therapy: Reviewing Current Best Practice to Provide High-Quality Extracorporeal Therapy to Critically Ill Patients.

Author information

1
Divisions of Pulmonary, Allergy, Critical Care, and Sleep Medicine; Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA; and Division of Nephrology, University of Arkansas for Medial Sciences, Little Rock, AK. Electronic address: michael.connor@emory.edu.
2
Divisions of Pulmonary, Allergy, Critical Care, and Sleep Medicine; Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA; and Division of Nephrology, University of Arkansas for Medial Sciences, Little Rock, AK.

Abstract

Continuous renal replacement therapy (CRRT) use continues to expand globally. Despite improving technology, CRRT remains a complex intervention. Delivery of high-quality CRRT requires close collaboration of a multidisciplinary team including members of the critical care medicine, nephrology, nursing, pharmacy, and nutrition support teams. While significant gaps in medical evidence regarding CRRT persist, the growing evidence base supports evolving best practice and consensus to define high-quality CRRT. Unfortunately, there is wide variability in CRRT operating characteristics and limited uptake of these best practices. This article will briefly review the current best practice on important aspects of CRRT delivery including CRRT dose, anticoagulation, dialysis vascular access, fluid management, and drug dosing in CRRT.

KEYWORDS:

Anticoagulation; CRRT; CRRT dose; Critical illness; Timing of dialysis

PMID:
28778360
DOI:
10.1053/j.ackd.2017.05.003
[Indexed for MEDLINE]

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