Continuous renal replacement therapy: understanding circuit hemodynamics to improve therapy adequacy.

Détails

ID Serval
serval:BIB_5F9D322A17F8
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Continuous renal replacement therapy: understanding circuit hemodynamics to improve therapy adequacy.
Périodique
Current opinion in critical care
Auteur(s)
Michel T., Ksouri H., Schneider A.G.
ISSN
1531-7072 (Electronic)
ISSN-L
1070-5295
Statut éditorial
Publié
Date de publication
12/2018
Peer-reviewed
Oui
Volume
24
Numéro
6
Pages
455-462
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Résumé
The utilization of continuous renal replacement therapy (CRRT) increases throughout the world. Technological improvements have made its administration easier and safer. However, CRRT remains associated with numerous pitfalls and issues.
Even if new-generation CRRT devices have built-in safety features, understanding basic concepts remains of primary importance.
CRRT circuits' maximum recommended lifespan (72 h) can often not be achieved. Such early artificial kidney failures are typically related to two processes: circuit clotting and membrane clogging. Although these processes are to some degree inevitable, they are facilitated by poor therapy management. Indeed, the majority of device-triggered alarms are associated with blood pump interruption, which through blood stasis, enhance clotting and clogging. If the underlying issue is not adequately managed, further alarms will rapidly lead to prolonged stasis and complete circuit clotting or clogging making its replacement mandatory. Hence, rapid recognition of issues triggering alarms is of paramount importance. Because most alarms are related to circuit's hemodynamics, a thorough understanding of these concepts is mandatory for the staff in charge of delivering the therapy.This review describes CRRT circuits, measured and calculated pressures and the way their knowledge might improve therapy adequacy.
Mots-clé
Acute Kidney Injury/therapy, Critical Care, Extracorporeal Circulation/instrumentation, Extracorporeal Circulation/methods, Extracorporeal Membrane Oxygenation, Hemodynamics/physiology, Humans, Patient Safety, Practice Guidelines as Topic, Renal Replacement Therapy/adverse effects, Renal Replacement Therapy/methods, Risk Assessment
Pubmed
Web of science
Création de la notice
29/10/2018 10:49
Dernière modification de la notice
18/09/2019 6:10
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