Cerdá J, Baldwin I, Honore P M, Villa G, Kellum John A, Ronco Claudio
Department of Medicine, Albany Medical College, Albany N.Y., USA.
Blood Purif. 2016;42(3):248-65. doi: 10.1159/000448527. Epub 2016 Aug 26.
This paper reports on the continuous renal replacement therapy (CRRT) technology group recommendations and research proposals developed during the 17th Acute Dialysis Quality Initiative Meeting in Asiago, Italy. The group was tasked to address questions related to the impact of technology on acute kidney injury management. We discuss technological aspects of the decision to initiate CRRT and the components of the treatment prescription and delivery, the integration of information technology (IT) on overall patient management, the incorporation of CRRT into other 'non-renal' extracorporeal technologies such as ECMO and ECCO2R and the use of sorbents in sepsis and propose new areas for future research. Instead of reviewing current knowledge, the group focused on developing a renovated research agenda that reflects current and future technological advances, centered on innovations in new equipment, membranes and IT that will permit the integration of patient care and decision-making processes for years to come.
本文报告了在意大利阿西亚戈举行的第17届急性透析质量改进会议期间制定的连续性肾脏替代治疗(CRRT)技术组建议和研究提案。该小组的任务是解决与技术对急性肾损伤管理的影响相关的问题。我们讨论了启动CRRT决策的技术方面、治疗处方和实施的组成部分、信息技术(IT)在整体患者管理中的整合、将CRRT纳入其他“非肾脏”体外技术(如体外膜肺氧合和体外二氧化碳清除)以及吸附剂在脓毒症中的应用,并提出了未来研究的新领域。该小组没有回顾当前的知识,而是专注于制定一个经过翻新的研究议程,该议程反映当前和未来的技术进步,以新设备、膜和IT方面的创新为核心,这些创新将在未来几年实现患者护理和决策过程的整合。