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In this 206th episode I welcome Dr. Derek Fine to the show to discuss the use of CRRT (Continuous Renal Replacement Therapy) in the ICU.
CME: https://earnc.me/VeyBxz
References:
Karkar and Ronco Ann. Prescription of CRRT: a pathway to optimize therapy. Intensive Care (2020) 10:32
Srijan Tandukar, MD; and Paul M. Palevsky, MD. Continuous Renal Replacement Therapy Who, When, Why, and How. CHEST 2019; 155(3):626-638.
The VA/NIH Acute Renal Failure Trial Network. Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury. N Engl J Med 2008;359:7-20.
The RENAL Replacement Therapy Study Investigators. Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients. N Engl J Med 2009;361:1627-38.
Great episode and I’ll definitely be pointing trainees to it as a nice primer on the topic.
I think it’s worth mentioning that a lot of drugs are dosed differently when on CRRT. When you’re making the decision to initiate or deescalate these therapies it’s probably worth reflexively running your medication list (potentially with an ICU pharmacist!) to make sure you’re not about to accidentally over or underdose your patient because you’re changing their clearance mechanics so dramatically.
Great point, thanks!