Examining Intensive Care Nurses' Clinical Decision-Making Associated with Acute Kidney Injury and Continuous Renal Replacement Therapy in Saudi Arabia

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.

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Continuous renal replacement therapy: understanding the foundations applied to pediatric patients

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v22i1.1115 ◽

2019 ◽

pp. S39-S45

Author(s):

Evelyn Obando ◽

Eliana López ◽

David Montoya ◽

Jaime Fernández Sarmiento

Keyword(s):

Acute Kidney Injury ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Continuous Renal Replacement Therapy ◽

Replacement Therapy ◽

Pediatric Patients ◽

Kidney Injury ◽

Rational Approach ◽

Daily Dialysis ◽

Continuous Renal Replacement Therapies

Continuous renal replacement therapy (CRRT) is a well-established supportive treatment for acute kidney injury in pediatric intensive care units. Knowing its basic aspects allows a rational approach to therapy, making this therapeutic option a more adaptable treatment for individual patient. Different strategies may be used in the same child, depending on the clinical situation and the changes that may present throughout the clinical course. This article explains the physical principles, modalities of continuous renal replacement therapies, and membrane and filter characteristics in order to better understand the transmembrane transport of fluids and solutes in continuous renal replacement therapy.Abbreviations: CRRT= Continuous renal replacement therapy; SCUF = Slow continuous ultrafiltration therapies; FF = Filtration fraction; CVVH = Continuous venovenous hemofiltration; AKI = Acute kidney injury; CVVHD = Continuous venovenous hemodialysis; CVVHDF = Continuous venovenous hemodiafiltration; SLEDD = Sustained low-efficiency daily dialysis, EDDf = Extended daily dialysis with filtration, PDIRRT = Prolonged daily intermittent renal replacement therapyCitation: Obando E, López E, Montoya D, Fernández-Sarmiento J. Continuous renal replacement therapy: understanding the foundations applied to pediatric patients. Anaesth Pain & Intensive Care 2018;22 Suppl 1:S39-S45

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

10.17504/protocols.io.bybmpsk6 ◽

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.

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