13.05.2024 | Editorial
When is the optimal time to stop continuous renal replacement therapy in children?
verfasst von:
Shaegan Irusen, Antoine Schneider, Michael Joannidis
Erschienen in:
Intensive Care Medicine
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Excerpt
Continuous renal replacement therapy (CRRT) is applied to 5–20% of critically ill patients and represents the main supportive therapy in severe acute kidney injury (AKI) [
1,
2]. In the past two decades, several key questions related to CRRT have been addressed: the dose, rate of fluid removal, anticoagulation and the timing for initiation. High quality studies have provided clues as to how to approach most of these issues to allow for uniformity across intensive care units and dialysis units. On the other hand, the question of CRRT cessation has merely been raised and needs further exploration. Correctly timing the termination of CRRT has major implications: unnecessary CRRT increases costs, workload for healthcare staff and patients’ length of stay. Conversely, failed weaning from CRRT might expose patients to recurrent fluid overload, inadequate metabolic control and might, therefore, hinder recovery. In the absence of high quality data, clinicians are left without due guidance at the bedside and practice appears to greatly vary across sites [
3]. …
