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Continuous Renal Replacement Therapy Update: An Emphasis on Safe and High-Quality Care
1Hildy Schell-Chaple is Clinical Nurse Specialist, University of California, San Francisco Medical Center, 505 Parnassus Ave, San Francisco, CA 94143 (hildegarde.schell-chaple@ucsf.edu).
Abstract:
Continuous renal replacement therapy (CRRT) was introduced more than 40 years ago as a renal support option for critically ill patients who had contraindications to intermittent hemodialysis and peritoneal dialysis. Despite being the most common renal support therapy used in intensive care units today, the tremendous variability in CRRT management challenges the interpretation of findings from CRRT outcome studies. The lack of standardization in practice and training of clinicians along with the high risk of CRRT-related adverse events has been the impetus for the recent expert consensus work on identifying quality indicators for CRRT programs. This article summarizes the potential complications that establish CRRT as a high-risk therapy and also the recently published best-practice recommendations for providing high-quality CRRT.
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