Objectives This chapter will: 1. Present the main bioethical problems associated with the management of renal replacement therapy (RRT) in critically ill patients. 2. Discuss a strategy, based on moral principles, for guiding the decision-making process. 3. Present a protocol…
Objectives This chapter will: 1. Identify the major factors affecting drug removal during renal replacement therapy (RRT). 2. Define the principles for appropriate dosage adjustments during RRT. 3. Describe the potential relevance of RRT in modifying the pharmacodynamic behavior of…
Objectives This chapter will: 1. Provide a clinical context for acute renal replacement therapy (RRT) dosing. 2. Discuss the role and limitations of urea kinetic modeling for the quantification of dose. 3. Discuss the concepts and demonstrate the use of…
Objectives This chapter will: 1. Describe the main dimensions of renal replacement therapy (RRT) dose: efficiency, intensity, and clinical efficacy. 2. Describe the most important studies addressing the impact of RRT dose on the survival of critically ill patients. 3.…
Objectives This chapter will: 1. Evaluate the factors that determine need for dialytic intervention in critically ill patients and describe the current status of initiation of renal replacement therapy in the intensive care unit (ICU). 2. Define and contrast approaches…
Objectives This chapter will: 1. Define the role of dialysis solutions and replacement fluids in the prescription of continuous renal replacement therapy (CRRT). 2. Provide updated information on the composition of commercially available CRRT solutions, focusing on the possibility to…
Anticoagulation Intermittent Hemodialysis Heparin Clotting Membrane There is a fine balance between hemostasis and hemorrhage in the human body, managed by a complex system of plasma, cellular, and endothelial factors. Coagulation is the normal process occurring when vascular injury results…
Objectives This chapter will: 1. Provide a brief history of the development and evolution of continuous renal replacement therapy (CRRT) systems. 2. Describe the basic features of CRRT machines, including the user interface, pumps, pressure monitoring, safety features, and anticoagulation…
Objectives This chapter will: 1. Describe the main components of filter and membranes for continuous renal replacement therapy (CRRT). 2. Characterize the performance parameters of filters and membranes. 3. Describe the fundamentals of solute and fluid transport in CRRT. Renal…
Objectives This chapter will: 1. Present a brief overview of the main components of the extracorporeal circulation for renal replacement therapies. 2. Explain the safety features involved in the delivery of these therapies. 3. Describe the implications of the principal…