Renal replacement therapy for the patient with acute traumatic brain injury and severe acute kidney injury.
Fortunately with improvements in initial medical resuscitation, such as the avoidance of nephrotoxins, the incidence of acute kidney injury requiring renal support in patients with acute traumatic brain injury remains low. However the incidence of cerebral hemorrhage in patients on chronic dialysis programs appears to be increasing. By carefully adapting renal replacement to minimize cardiovascular instability and reduce the rate of change of serum osmolality, patient survival in this group of critically ill patients is increasing and starting to approach that of patients with traumatic brain injury without kidney injury.
Davenport
Andrew
A
Centre for Nephrology, Division of Medicine, Department of Medicine, Royal Free and University College Medical School, London, UK. andrew.davenport@royalfree.nhs.uk
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000150:complications* / Q000628:therapy*; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001930:Brain Injuries / Q000150:complications*; D002543:Cerebral Hemorrhage / Q000517:prevention & control; D003374:Coumarins / Q000009:adverse effects / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D017582:Renal Replacement Therapy / Q000379:methods*; D015996:Survival Rate
D000925:Anticoagulants; D003374:Coumarins