- Dedication
- Preface
- Contributors
- Chapter 1 The Critically Ill Patient with Acute Kidney Injury
- Chapter 2 History and Rationale for Continuous Renal Replacement Therapy
- Chapter 3 Nomenclature for Renal Replacement Therapy in Acute Kidney Injury
- Chapter 4 Basic Principles of Solute Transport
- Chapter 5 Principles of Fluid Management in the Intensive Care Unit
- Chapter 6 Indications, Timing, and Patient Selection
- Chapter 7 Biomarkers for Initiation of Renal Replacement Therapy
- Chapter 8 Extended Indications
- Chapter 9 Dose Adequacy and Assessment
- Chapter 10 Acid–Base and Electrolyte Disorders
- Chapter 11 Choosing a Renal Replacement Therapy in Acute Kidney Injury
- Chapter 12 Vascular Access for Continuous Renal Replacement Therapy
- Chapter 13 The Circuit and the Prescription
- Chapter 14 The Membrane
- Chapter 15 Fluids for Continuous Renal Replacement Therapy
- Chapter 16 Alarms and Troubleshooting
- Chapter 17 Nonanticoagulation Strategies to Optimize Circuit Function in RRT
- Chapter 18 Anticoagulation
- Chapter 19 Regional Citrate Anticoagulation
- Chapter 20 Drug Dosing in Continuous Renal Replacement Therapy
- Chapter 21 Renal Replacement Therapy in Children
- Chapter 22 Therapeutic Plasma Exchange in Critical Care Medicine
- Chapter 23 MARS
- Chapter 24 Sorbents
- Chapter 25 Hybrid Therapies
- Chapter 26 The ICU Environment
- Chapter 27 Patient Care Quality and Teamwork
- Chapter 28 Organizational Aspects
- Chapter 29 Documentation, Billing, and Reimbursement for Continuous Renal Replacement Therapy
- Chapter 30 Machines for Continuous Renal Replacement Therapy
- Chapter 31 Quality Improvement for Continuous Renal Replacement Therapies
- Chapter 32 Educational Resources
- Glossary
- Index
(p. 111) The Circuit and the Prescription
- Chapter:
- (p. 111) The Circuit and the Prescription
- Author(s):
Rinaldo Bellomo
and Ian Baldwin
- DOI:
- 10.1093/med/9780190225537.003.0013
There is no evidence to suggest that choosing CRRT based on hemofiltration over hemodiafiltration or over hemodialysis leads to clinically important differences in outcomes. There is a clear difference, however, in terms of the nature of solute removal with convection (filtration) leading to essentially equal small solute removal but much greater middle molecular weight solute removal. It is unclear, however, whether this effect matters pathophysiologically or clinically. Because of such uncertainty, physicians and nurses choose a particular approach in a given unit (typically based on local tradition, comfort, ease of operation etc.) and apply it consistently to all patients. Epidemiological data suggest that continuous veno-venous hemodiafiltration (CVVHDF) with replacement fluid delivered in pre-dilution mode may be the most common approach to CRRT worldwide, followed by continuous veno-venous hemofiltration (CVVH) also with pre-dilution.
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- Dedication
- Preface
- Contributors
- Chapter 1 The Critically Ill Patient with Acute Kidney Injury
- Chapter 2 History and Rationale for Continuous Renal Replacement Therapy
- Chapter 3 Nomenclature for Renal Replacement Therapy in Acute Kidney Injury
- Chapter 4 Basic Principles of Solute Transport
- Chapter 5 Principles of Fluid Management in the Intensive Care Unit
- Chapter 6 Indications, Timing, and Patient Selection
- Chapter 7 Biomarkers for Initiation of Renal Replacement Therapy
- Chapter 8 Extended Indications
- Chapter 9 Dose Adequacy and Assessment
- Chapter 10 Acid–Base and Electrolyte Disorders
- Chapter 11 Choosing a Renal Replacement Therapy in Acute Kidney Injury
- Chapter 12 Vascular Access for Continuous Renal Replacement Therapy
- Chapter 13 The Circuit and the Prescription
- Chapter 14 The Membrane
- Chapter 15 Fluids for Continuous Renal Replacement Therapy
- Chapter 16 Alarms and Troubleshooting
- Chapter 17 Nonanticoagulation Strategies to Optimize Circuit Function in RRT
- Chapter 18 Anticoagulation
- Chapter 19 Regional Citrate Anticoagulation
- Chapter 20 Drug Dosing in Continuous Renal Replacement Therapy
- Chapter 21 Renal Replacement Therapy in Children
- Chapter 22 Therapeutic Plasma Exchange in Critical Care Medicine
- Chapter 23 MARS
- Chapter 24 Sorbents
- Chapter 25 Hybrid Therapies
- Chapter 26 The ICU Environment
- Chapter 27 Patient Care Quality and Teamwork
- Chapter 28 Organizational Aspects
- Chapter 29 Documentation, Billing, and Reimbursement for Continuous Renal Replacement Therapy
- Chapter 30 Machines for Continuous Renal Replacement Therapy
- Chapter 31 Quality Improvement for Continuous Renal Replacement Therapies
- Chapter 32 Educational Resources
- Glossary
- Index