Practical considerations for the dosing and adjustment of continuous renal replacement therapy in the intensive care unit

Samuel M Galvagno Jr; Caron M Hong; Matthew E Lissauer; Andrew K Baker; Sarah B Murthi; Daniel L Herr; Deborah M Stein

doi:10.1016/j.jcrc.2013.05.018

Practical considerations for the dosing and adjustment of continuous renal replacement therapy in the intensive care unit

J Crit Care. 2013 Dec;28(6):1019-26. doi: 10.1016/j.jcrc.2013.05.018. Epub 2013 Jul 24.

Authors

Samuel M Galvagno Jr¹, Caron M Hong, Matthew E Lissauer, Andrew K Baker, Sarah B Murthi, Daniel L Herr, Deborah M Stein

Affiliation

¹ Division of Critical Care Medicine, Department of Anesthesiology, University of Maryland Medical School, Baltimore, MD; Division of Trauma Anesthesiology, Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland Medical School, Baltimore, MD. Electronic address: sgalvagno@anes.umm.edu.

PMID: 23890937
DOI: 10.1016/j.jcrc.2013.05.018

Abstract

Familiarity with the initiation, dosing, adjustment, and termination of continuous renal replacement therapy (CRRT) is a core skill for contemporary intensivists. Guidelines for how to administer CRRT in the intensive care unit are not well documented. The purpose of this review is to discuss the modalities, terminology, and components of CRRT, with an emphasis on the practical aspects of dosing, adjustments, and termination. Management of electrolyte and acid-base derangements commonly encountered with acute renal failure is emphasized. Knowledge regarding the practical aspects of managing CRRT in the intensive care unit is a prerequisite for achieving desired physiological end points.

Keywords: Continuous renal replacement therapy; Dosing; Intensive care unit.

Published by Elsevier Inc.

Publication types

Review

MeSH terms

Acid-Base Equilibrium
Critical Care / methods*
Critical Illness / therapy*
Humans
Intensive Care Units*
Renal Replacement Therapy / methods*
Water-Electrolyte Balance