scholarly journals Comparing prescribed and delivered doses in ICU patients on continuous renal replacement therapy at King Fahad Hospital Saudi Arabia.

2020 ◽  
Vol 27 (03) ◽  
pp. 601-606
Author(s):  
Adil Manzoor ◽  
Ahmed Bhatt ◽  
Gurdeep Singh ◽  
Faisel Yunus
Keyword(s):  
Acute Kidney Injury ◽  
Saudi Arabia ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
P Value ◽  
Average Dose ◽  
Mean Flow

The outcomes of several studies   to assess the dose of dialysis during renal replacement therapy (RRT) created confusion among the clinicians to considered that dose of dialysis can influence the outcomes of patients with acute kidney injury (AKI). Suitable dose of CRRT is associated with improved survival in critically ill patients with acute kidney injury (AKI). Among different studies Effluent Volume per weight and unit time (mL/kg/h) used to express prescribed effluent rates, in our study same unit used express the effluent rates. Purpose of this study is to find the difference among dosage of CRRT based on effluent rate prescription and actual delivered effluent rate by monitoring records of dialysis. Study Design: Prospective observational cohort study. Setting: King Fahad Hospital Medina Saudi Arabia. Period: 1st June 2016 to 31st December 2016. Material & Methods: Two hundred acute kidney injury patients admitted in ICU on CRRT at rate of 20ml/kg using pre-filter continuous venovenous hemodia-filtration (CVVHDF), among (AKI) patients prescribed doses were compared with the actual dose with in the duration of 24 hours to find out   difference between   prescribed and actual dose. Results: Findings of our study shows that. Mean average dose of dialysis delivered per day was only 16 hours which is 21% of prescription of pre-dilution CVVHDF.  Patients were receiving 14ml/Kg of continues renal replacement therapy (CRRT) with the lack of 21% dilution correction factor. The average number of hours/day on continuous renal replacement therapy was 14.1±2.41, with a mean flow rate of 1.36±0.31 L/h (averaged over 24 h). The delivered doses were significantly lowered then the prescribed doses with (P < 0.001). 30% of doses was missing during CRRT among patients with acute kidney diseases admitted in ICU at king Fahad hospital Saudi Arabia (P-value <0.001). Conclusions: We concluded that during dialysis patients did not received the prescribed dose in comparison to actual delivered dose which effects the survival of critical ill patients with acute kidney injury.

The Impact of Hemodynamic Transesophageal Echocardiography on the Use of Continuous Renal Replacement Therapy in Trauma

2017 ◽  
Vol 83 (8) ◽  
pp. 855-859 ◽  
Author(s):  
Madison Griffin ◽  
Brett Howard ◽  
Sam Devictor ◽  
Josh Ferenczy ◽  
Frances Cobb ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Transesophageal Echocardiography ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Volume Overload ◽  
P Value ◽  
Trauma Patients ◽  
The Impact

Post-traumatic fluid management is a widely debated topic. No best-practice consensus exists. Adverse outcomes such as acute kidney injury or volume overload are common. Continuous renal replacement therapy (CRRT) is an adjunct therapy for severe acute renal failure and volume overload, but is costly and not without risk. Hemodynamic transesophageal echocardiography (hTEE) is widely accepted as a reliable way to monitor volume status of intensive care unit (ICU) patients. Although data exist evaluating hTEE and CRRT independently, there is a lack of research mutually inclusive of the two. We hypothesized that the use of hTEE is associated with less need for CRRT. Retrospective review of a level I trauma center from 2009 to 2015 identified patients that required CRRT. In 2013, we implemented a protocol using hTEE in trauma patients with significant resuscitation needs. We compared CRRTuse before and after implementation of the protocol (pre- and post-hTEE). Multivariate analysis using two sample t tests and χ2 test of the odds ratio (O.R.) was completed on variables such as injury severity score (ISS), acute kidney injury network (AKIN), days of CRRT, ICU length of stay (LOS), and hospital LOS. A total of 5037 and 6699 trauma patients were evaluated in the pre- and post-hTEE groups, respectively. Mean ISS was 22 and 28 for pre- and post-hTEE, respectively (P value 0.19). Mean AKIN was 2.7 for both groups. Mean days on CRRT was eight before hTEE and seven after hTEE (P value 0.7); 23 patients required CRRT pre-hTEE, and 15 required CRRT post-hTEE (P value 0.01 O.R. 2.4). Given, the odds of CRRT pre-hTEE are more than twice that of CRRT post-hTEE; we conclude that the use of hTEE is associated with a reduction of CRRT.

scholarly journals The Effect of Specialized Continuous Renal Replacement Therapy Team in Acute Kidney Injury Patients Treatment

2015 ◽  
Vol 56 (3) ◽  
pp. 658 ◽  
Author(s):  
Youn Kyung Kee ◽  
Eun Jin Kim ◽  
Kyoung Sook Park ◽  
Seung Gyu Han ◽  
In Mee Han ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Therapy Team

scholarly journals Net ultrafiltration rate and its impact on mortality in patients with acute kidney injury receiving continuous renal replacement therapy

2019 ◽  
Author(s):  
Shahrzad Tehranian ◽  
Khaled Shawwa ◽  
Kianoush B Kashani
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
High Intensity ◽  
Kidney Injury ◽  
Ultrafiltration Rate ◽  
Baseline Serum ◽  
Fluid Removal ◽  
The Impact

Abstract Background Fluid overload, a critical consequence of acute kidney injury (AKI), is associated with worse outcomes. The optimal fluid removal rate per day during continuous renal replacement therapy (CRRT) is unknown. The purpose of this study is to evaluate the impact of the ultrafiltration rate on mortality in critically ill patients with AKI receiving CRRT. Methods This was a retrospective cohort study where we reviewed 1398 patients with AKI who received CRRT between December 2006 and November 2015 at the Mayo Clinic, Rochester, MN, USA. The net ultrafiltration rate (UFNET) was categorized into low- and high-intensity groups (&lt;35 and ≥35 mL/kg/day, respectively). The impact of different UFNET intensities on 30-day mortality was assessed using logistic regression after adjusting for age, sex, body mass index, fluid balance from intensive care unit (ICU) admission to CRRT initiation, Acute Physiologic Assessment and Chronic Health Evaluation III and sequential organ failure assessment scores, baseline serum creatinine, ICU day at CRRT initiation, Charlson comorbidity index, CRRT duration and need of mechanical ventilation. Results The mean ± SD age was 62 ± 15 years, and 827 (59%) were male. There were 696 patients (49.7%) in the low- and 702 (50.2%) in the high-intensity group. Thirty-day mortality was 755 (54%). There were 420 (60%) deaths in the low-, and 335 (48%) in the high-intensity group (P &lt; 0.001). UFNET ≥35 mL/kg/day remained independently associated with lower 30-day mortality (adjusted odds ratio = 0.47, 95% confidence interval 0.37–0.59; P &lt; 0.001) compared with &lt;35 mL/kg/day. Conclusions More intensive fluid removal, UFNET ≥35 mL/kg/day, among AKI patients receiving CRRT is associated with lower mortality. Future prospective studies are required to confirm this finding.

Impact of Continuous Renal Replacement Therapy Intensity on Septic Acute Kidney Injury

Shock ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Kengo Mayumi ◽  
Tetsushi Yamashita ◽  
Yoshifumi Hamasaki ◽  
Eisei Noiri ◽  
Masaomi Nangaku ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Septic Acute Kidney Injury
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