Department of Nephrology, National Institute of Cardiology Mexico, Mexico City, Mexico.
Division of Nephrology, Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Nephron. 2021;145(2):91-98. doi: 10.1159/000512846. Epub 2021 Feb 4.
Acute kidney injury (AKI) is common in critically ill patients, and renal replacement therapy (RRT) constitutes an important aspect of acute management during critical illness. Continuous RRT (CRRT) is frequently utilized in intensive care unit settings, particularly in patients with severe AKI, fluid overload, and hemodynamic instability. The main goal of CRRT is to timely optimize solute control, acid-base, and volume status. Total effluent dose of CRRT is a deliverable that depends on multiple factors and therefore should be systematically monitored (prescribed vs. delivered) and iteratively adjusted in a sustainable mode. In this manuscript, we review current evidence of CRRT dosing and provide recommendations for its implementation as a quality indicator of CRRT delivery.
急性肾损伤（AKI）在危重症患者中较为常见，肾脏替代治疗（RRT）是危重症期间急性管理的重要方面。连续性肾脏替代治疗（CRRT）在重症监护病房中经常使用，特别是在严重 AKI、液体超负荷和血流动力学不稳定的患者中。CRRT 的主要目标是及时优化溶质控制、酸碱和容量状态。CRRT 的总流出剂量是一个取决于多种因素的可交付成果，因此应系统地监测（规定与提供）并以可持续的方式进行迭代调整。在本文中，我们回顾了 CRRT 剂量的现有证据，并为其实施提供了建议，作为 CRRT 输送的质量指标。
