[Application of continuous renal replacement therapy in coronavirus disease 2019]

Area of Science:

• Nephrology
• Critical Care Medicine
• Infectious Diseases

Background:

• Continuous renal replacement therapy (CRRT) is a cornerstone of organ support in intensive care units (ICUs).
• The COVID-19 pandemic introduced unique challenges, necessitating specific considerations for CRRT application.
• Existing CRRT protocols require adaptation due to COVID-19's distinct pathophysiology and clinical presentation.

Purpose of the Study:

• To elucidate the similarities and differences between CRRT in COVID-19 patients and standard CRRT protocols.
• To provide guidance on optimizing CRRT management in the context of COVID-19.
• To address key aspects including safety, indications, operations, anticoagulation, fluid management, and infection control.

Main Methods:

• Comparative analysis of CRRT in COVID-19 versus non-COVID-19 critically ill patients.
• Review of current literature and expert consensus on CRRT in infectious disease scenarios.
• Examination of specific CRRT parameters: safety, accessibility, timing, anticoagulation, and fluid management.

Main Results:

• CRRT in COVID-19 presents unique challenges in anticoagulation and infection control compared to routine care.
• Indications and timing for initiating CRRT may differ based on COVID-19-specific hyperinflammation and acute kidney injury.
• Adaptations in fluid management and clinical operations are crucial for safe and effective CRRT in COVID-19 patients.

Conclusions:

• CRRT management for COVID-19 requires tailored approaches, distinct from standard protocols.
• Understanding these differences is critical for improving patient outcomes and ensuring safety.
• Further research is needed to refine CRRT guidelines for infectious etiologies.