Information technology for CRRT and dose delivery calculator

The application of information technology (IT) to the field of critical care nephrology is a process that may reduce errors in care delivery, improve monitoring, decrease unintentional practice variation, increase the quality and accuracy of delivered treatments.

This review presents some examples of potential applications of recent IT achievements to clinical practice.

The adequacy calculator for continuous therapy dose prescription was recently shown to accurately predict urea clearance. When clearances above 60 ml/min where prescribed, the calculator tended to overestimate effective clearances; this overestimation generally remained within an error of 15%. Nevertheless, the delivered Kt/V in 24 h will always approach the target value of 1.2. The use of the calculator enabled strict monitoring of treatments. Furthermore, the so-called 'next generation' machines have technical characteristics in common that allow the highest safety and accuracy levels: some of these aspects are addressed and commented on in the present review.

IT is having and will likely have a significant impact on patient safety, practice variation, patient assessment and monitoring, and documentation of the demographics of acute renal failure and dialysis. One of the most recent and potentially interesting aspects of IT implementation on acute dialysis might be the renal replacement dose monitoring and calculation: close control of the therapy delivery and, eventually, prescription adjustments might be optimized.