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Continuous renal replacement therapy under special conditions like sepsis, burn, cardiac failure, neurotrauma, and liver failure.
Davenport, Andrew; Honore, Patrick M.
  • Davenport A; Royal Free London NHS Foundation Trust, London, UK.
  • Honore PM; ICU Department, Centre Hospitalier Universitaire Brugmann-Brugmann University Hospital, ULB University, Brussels, Belgium.
Semin Dial ; 34(6): 457-471, 2021 11.
Article in English | MEDLINE | ID: covidwho-1376444
ABSTRACT
Continuous renal replacement therapy (CRRT) in sepsis does have a role in removing excessive fluid, and also role in removal of mediators although not proven today, and to allow fluid space in order to feed. In these conditions, continuous renal replacement therapy can improve morbidity but never mortality so far. Regarding sepsis, timing has become a more important issue after decades and is currently more discussed than dosing. Rationale of blood purification has evolved a lot in the last years regarding sepsis with the discovery of many types of sorbent allowing ideas from science fiction to become reality in 2021. Undoubtedly, COVID-19 has reactivated the interest of blood purification in sepsis but also in COVID-19. Burn is even more dependent about removal of excessive fluid as compared to sepsis. Regarding cardiac failure, ultrafiltration can improve the quality of life and morbidity when diuretics are becoming inefficient but can never improve mortality. Regarding brain injury, CRRTs have several advantages as compared to intermittent hemodialysis. In liver failure, there have been no randomized controlled trials to examine whether single-pass albumin dialysis offers advantages over standard supportive care, and there is always the cost of albumin.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Burns / Liver Failure / Sepsis / Acute Kidney Injury / Continuous Renal Replacement Therapy / COVID-19 / Heart Failure Type of study: Controlled clinical trial / Randomized controlled trials Limits: Humans Language: English Journal: Semin Dial Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: Sdi.13002

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Burns / Liver Failure / Sepsis / Acute Kidney Injury / Continuous Renal Replacement Therapy / COVID-19 / Heart Failure Type of study: Controlled clinical trial / Randomized controlled trials Limits: Humans Language: English Journal: Semin Dial Journal subject: Nephrology Year: 2021 Document Type: Article Affiliation country: Sdi.13002