ICU SAQs · AKI & RRT
Dose and anticoagulation of continuous renal replacement therapy
Tests the delivered-dose target for CRRT and the RENAL trial evidence behind it, plus a practical appraisal of regional citrate, systemic heparin and anticoagulation-free strategies.
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Prompt
A 58-year-old woman with severe AKI from septic shock has just been commenced on continuous venovenous haemodiafiltration for refractory hyperkalaemia and fluid overload. What effluent dose should be prescribed, what is the evidence for that target, and outline the options for anticoagulating the circuit with their advantages and disadvantages.
Question
A 58-year-old woman with severe AKI from septic shock has just been commenced on continuous venovenous haemodiafiltration for refractory hyperkalaemia and fluid overload. What effluent dose should be prescribed, what is the evidence for that target, and outline the options for anticoagulating the circuit with their advantages and disadvantages.
References3ShowHide
- [1]Bellomo R, Cass A, Cole L, et al. Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients (RENAL). New England Journal of Medicine, 2009.PMID 19846848
- [2]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [3]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.