Continuous Renal Replacement Therapy Comparing Continuous Venovenous Hemofiltration (CVVH) Vs Continuous Venovenous Hemodifiltration(CVVHDF) In Reducing Mortality In The Intensive Care Units

2012 ◽  
Author(s):  
Farhan Z. ALenezi
Keyword(s):  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Intensive Care Units ◽  
Continuous Venovenous Hemofiltration

Renal Support Therapy

2018 ◽  
Author(s):  
Samuel M Galvagno Jr ◽  
Anthony E Tannous
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Surgical Intensive Care Unit ◽  
Continuous Venovenous Hemofiltration ◽  
Surgical Intensive Care ◽  
Core Skill ◽  
Renal Support Therapy

Knowledge regarding the practical aspects of managing continuous renal replacement therapy (CRRT) in the surgical intensive care unit is a prerequisite for achieving desired physiologic end points. Familiarity with the initiation, dosing, adjustment, and termination of CRRT is a core skill for surgical intensivists. Modalities, terminology, and components of CRRT are discussed in this review, with an emphasis on the practical aspects of dosing, adjustments, and termination. Filter selection and management of electrolyte and acid-base derangements are emphasized. Key words: continuous renal replacement therapy, continuous venovenous hemofiltration, continuous venovenous hemofiltration dialysis, dialysis, intensive care unit

Continuous renal replacement therapy for critically ill patients in the intensive care units of two tertiary hospitals. v1

2021 ◽  
Author(s):  
Jorge not provided not provided Machado Alba
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Severity Scores

Introduction: Acute kidney injury is characterized by a sudden decrease in renal function. The objective was to determine the variables that are associated with the need for continuous renal replacement therapy and its outcome in critically ill patients treated in two intensive care units. Methods. A cohort follow-up study with reviewed clinical histories of 140 patients admitted between January-2012 and July-2015, who were receiving continuous therapy, and the main outcome was survival after discharge. Clinical variables, severity scores, disease prognosis, continuous renal replacement techniques and outcomes were collected. Results. Mean age was 61.9±17.6 years, and 60.7% were men. Septic shock was the main cause of acute kidney injury. In total, 79.4% of cases died in the intensive care units. The median dose of continuous renal replacement therapy was 28 ml/kg/hour (interquartile range: 35-37). The late initiation of the therapy between 25-72 hours after the diagnosis increased the probability that the patient would experience a fatal outcome (OR:6.9, 95%CI:1.5-33.0). Conclusions: Acute kidney injury secondary to sepsis is a frequent condition in critically ill patients and is associated with high mortality rates. In these cases, continuous renal replacement therapy was the main recourse for its treatment.

Early Mobility Activities During Continuous Renal Replacement Therapy

2014 ◽  
Vol 23 (4) ◽  
pp. 348-351 ◽  
Author(s):  
Cherylynn A. Brownback ◽  
Patricia Fletcher ◽  
Lynelle N. B. Pierce ◽  
Susan Klaus
Keyword(s):  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Intensive Care Units ◽  
Bed Rest ◽  
Therapeutic Technique ◽  
Early Mobility ◽  
Hemodynamic State

Continuous renal replacement therapy (CRRT) is a therapeutic technique used to support critically ill patients with acute renal failure in intensive care units. CRRT is preferred over hemodialysis for patients who cannot tolerate the rapid fluid and electrolyte shifts associated with hemodialysis because of their tenuous hemodynamic state. Traditionally, such patients have not been candidates for mobilization and have remained on strict bed rest. Mobilization is now being initiated on patients undergoing CRRT in intensive care units. This case study chronicles the successful mobilization of a patient undergoing CRRT. This experience suggests that CRRT patients who are appropriate candidates may be mobilized safely and therefore should not automatically be excluded from mobilization therapies.

scholarly journals Pharmacokinetics of Levofloxacin and Ciprofloxacin during Continuous Renal Replacement Therapy in Critically Ill Patients

2001 ◽  
Vol 45 (10) ◽  
pp. 2949-2954 ◽  
Author(s):  
Rebecca S. Malone ◽  
Douglas N. Fish ◽  
Edward Abraham ◽  
Isaac Teitelbaum
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Effective Drug ◽  
Continuous Venovenous Hemofiltration ◽  
Drug Concentrations

ABSTRACT The pharmacokinetics of intravenously administered levofloxacin and ciprofloxacin were studied in intensive care unit patients during continuous venovenous hemofiltration (CVVH; four patients received levofloxacin, and five received ciprofloxacin) or hemodiafiltration (CVVHDF; six patients received levofloxacin, and five received ciprofloxacin). Levofloxacin clearance was substantially increased during both CVVH and CVVHDF, while ciprofloxacin clearance was affected less. The results of this study suggest that doses of levofloxacin of 250 mg/day and ciprofloxacin of 400 mg/day are sufficient to maintain effective drug concentrations in the plasma of patients undergoing CVVH or CVVHDF.

scholarly journals Continuous renal replacement therapy: Should the cardiologist be able to manage it out of intensive care units?

2011 ◽  
Vol 150 (2) ◽  
pp. 233-235
Author(s):  
Cristina Giglioli ◽  
Valentina Spini ◽  
Daniele Landi ◽  
Alessio Mattesini ◽  
Serafina Valente ◽  
...  
Keyword(s):  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Intensive Care Units

scholarly journals Beta-Lactam Dosing During Continuous Renal Replacement Therapy: A Survey of Practices in French Intensive Care Units

2021 ◽  
Author(s):  
Elodie Matusik ◽  
Justine Lemtiri ◽  
Guillaume Wabont ◽  
Fabien Lambiotte
Keyword(s):  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Intensive Care Units ◽  
Current Practice ◽  
Therapeutic Drug ◽  
Beta Lactam ◽  
Wide Range ◽  
Dosing Regimens

Abstract BackgroundLittle information is available on current practice in beta-lactam dosing during continuous renal replacement therapy (CRRT). Optimized dosing is essential for improving outcomes, and there is no consensus on the appropriate dose regimens. The objective of the present study was to describe current practice for beta-lactam dosing during CRRT in intensive care units (ICUs).MethodsWe conducted a nationwide survey by e-mailing an online questionnaire to physicians working in ICUs in France. The questionnaire included three sections: demographic characteristics, CRRT practices, and beta-lactam dosing regimens during CRRT.Results157 intensivists completed the questionnaire. Continuous venovenous hemofiltration was the most frequently used CRRT technique, and citrate was the most regularly used anticoagulant. The median prescribed dose at baseline was 30 mL/kg/h. The majority of prescribers (57%) did not reduce beta-lactam dosing during CRRT. The tools were used to adapt dosing regimens during CRRT included guidelines, therapeutic drug monitoring (TDM), and data from the literature. When TDM was used, 100% T > 4 time the MIC was the most common mentioned pharmacokinetic/pharmacodynamic target (53%). Pharmacokinetic software tools were rarely used. Prolonged or continuous infusions were widely used during CRRT (88%). Institutional guidelines on beta-lactam dosing during CRRT were rare. 41% of physicians sometimes consulted another specialist before adapting the dose of antibiotic during CRRT.ConclusionsOur present results highlight the wide range of beta-lactam dosing practices adopted during CRRT. Personalized TDM and the implementation of Bayesian software appear to be essential for optimizing beta-lactam dosing regimens and improving patient outcomes.

scholarly journals Impact of Continuous Renal Replacement Therapy as Treatment for Sepsis-Associated Acute Kidney Injury on Lactate Levels and the Risk of 28-Day Mortality in Intensive Care Units

2021 ◽  
Author(s):  
Luming Zhang ◽  
Zichen Wang ◽  
Fengshuo Xu ◽  
Yinlong Ren ◽  
Didi Han ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Intensive Care Units ◽  
Lactate Level ◽  
Kidney Injury ◽  
Joint Model ◽  
Lactate Levels

Abstract Background: Sepsis has high incidence and fatality rates in intensive care units, often leading to renal failure. The effectiveness of continuous renal replacement therapy (CRRT) in sepsis-associated acute kidney injury (S-AKI) patients is currently uncertain.Aim: Joint mode was used to determine the effect of CRRT on the lactate levels and survival of S-AKI patients.Methods: A retrospective study was applied to patients with sepsis and AKI, which were extracted from the MIMIC-III public database, with the endpoint being 28-day mortality. Every lactate level measurement within 28 days was observed and calculated using logarithms. Joint model combined the longitudinal analysis of the natural logarithm of the lactate level [log(lactate)] in longitudinal submodel and Cox regression by trajectory function, demonstrating the effects of CRRT on 28-day survival and log(lactate) changes, and its final relationship with the event status.Results: Among the 717 S-AKI patients, 157 received CRRT. CRRT was not associated with 28-day mortality. After adjustments, the relationship between CRRT use and log(lactate) elevation was statistically significant. The parameter estimation of CRRT and log(lactate) indicated that using CRRT will increase log(lactate) by 0.041 in S-AKI patients. The joint model also instigated a fixed association between changes in the lactate level and the event result, revealing an exp value of (1.755) =5.78, indicating that an increase of one unit in log(lactate) will increase the risk of 28-day mortality 5.78-fold. Conclusion: CRRT does not improve the prognosis of patients with sepsis and acute kidney injury in critical-care units and has a tendency of increasing lactate levels, which is a significant risk factor for the prognosis.

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