Continuous renal replacement therapies: a brief primer for the neurointensivist.
Continuous renal replacement therapy (CRRT) is a renal replacement modality that is often used in the ICU setting, including the neuro-ICU. This form of renal replacement therapy has been used classically for acute renal failure in patients with hemodynamic compromise, but is gaining acceptance as a method to control vascular and extra-vascular volume and mediate cytokines in non-renal diseases. Although these uses are briefly discussed, this review concentrates on the different forms of continuous renal replacement, mainly focusing on the technology of convective versus diffusive modalities and briefly on filter technology. There is also discussion on the various anticoagulation regimes used in CRRT including data on performing CRRT without anticoagulation. This review is not meant to be a discussion on the pros and cons of CRRT versus intermittent dialysis, but rather a primer on the technology of CRRT and how this therapy may affect general care of the ICU patient.
Patel
Pritesh
P
Department of Medicine, Louisiana State University Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71130, USA.
Nandwani
Veena
V
McCarthy
Paul J
PJ
Conrad
Steven A
SA
Keith Scott
L
L
D058186:Acute Kidney Injury / Q000628:therapy; D000925:Anticoagulants / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods*; D004867:Equipment Design; D005374:Filtration / Q000379:methods; D006440:Hemofiltration / Q000379:methods; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000295:instrumentation / Q000379:methods*; D006435:Renal Dialysis / Q000379:methods*; D017582:Renal Replacement Therapy / Q000379:methods*
D000925:Anticoagulants; D006493:Heparin