May 11, 2007

CRRT around the web

I've recently become interested in continuous renal replacement therapy (CRRT) which is basically a long, slow dialysis used to treat acute renal failure (ARF). Instead of doing a 3-4 hour dialysis, CRRT can last 24 hours and longer. It can include hemodialysis, hemodiafiltration, or hemofiltration. It is generally performed in a hospital setting, unlike standard dialysis which is performed at a dialysis clinic.

Some recent links on CRRT:

At forum, someone asks has anyone ever recovered after CRRT treatment? Some of the people replying actually have!

News Around the State has an article: Continuous Renal Replacement Therapy Proves More Beneficial Than Routine Dialysis for Some Patients, which states that CRRT has become more popular in the last 3 to 5 years. With the benefits being “Patients with marginal blood pressure seem to tolerate this treatment better hemodynamically. It is safer for these types of patients, and we are able to manage fluid volumes more easily with this treatment.” and “This treatment is easier for the nurses to maintain than previous methods. It is not as time consuming as previous comparable therapies, which allows the nurses to provide better patient care.”

icuroom pearls explains why citrate is used instead of heparin in CRRT. (In my experience hospitals use one or the other, but citrate is gaining favor)

Critical Care Blog, cites a recent article, One of the benefits of CRRT: the inherent stability of CRRT may avoid the renal ischaemia caused by hypotension associated with intermittent haemodialysis (IHD).

CJASN has an article by Jonathan Himmelfarb titled: Continuous Renal Replacement Therapy in the Treatment of Acute Renal Failure: Critical Assessment Is Required, which concludes "there is no convincing evidence to support superiority of CRRT over IHD in the treatment of critically ill patients with ARF."

Nephrology Rounds: has an issue on Acute Renal Failure in the Intensive Care Unit.

roxy_reXie has a 5 minute video of CRRT prep work at St. Luke's, unfortunately she doesn't say what she's doing it as she goes along, so it is hard to follow unless you already know what she is doing.

That is all I can find right now, I'll try to follow up this post with more details at a later date.

UPDATE: I've been slowly updating a CRRT info page. I'm biased on the subject however!
UPDATE2: Now a CRRT info blog for a more focused look on the subject.