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Continuous renal replacement therapy and the COVID pandemic.
Jacob S Stevens1,2, Juan Carlos Q Velez3,4, Sumit Mohan1,2,5
1Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Seminars in Dialysis
|March 11, 2021
Summary
Severe COVID-19 can cause acute kidney injury (AKI), increasing the need for renal replacement therapies (RRTs). Planning for RRT surges is crucial for healthcare systems during pandemics.
Area of Science:
- Nephrology
- Critical Care Medicine
- Public Health Preparedness
Background:
- Severe COVID-19 is associated with cytokine storm and vasodilatory shock, frequently leading to ischemic acute kidney injury (AKI).
- The surge in patients with severe AKI necessitates renal replacement therapies (RRTs), posing a significant burden on healthcare systems.
- Increased demand for nephrology services during pandemics like COVID-19 highlights the need for robust disaster response planning.
Purpose of the Study:
- To outline the challenges and considerations for developing a disaster response plan for RRT programs during a pandemic.
- To emphasize the importance of proactive inventory and contingency planning for RRT services.
Main Methods:
- Detailed review of RRT program components including personnel, consumables, and equipment.
- Development of disaster contingency protocols for anticoagulation strategies.
- Exploration of shared RRT models for surge capacity.
Main Results:
- Proactive inventory of RRT resources is essential before demand surges.
- Contingency protocols for anticoagulation and shared RRT models are critical for managing increased patient loads.
- Effective disaster planning can mitigate the overwhelming impact on healthcare systems.
Conclusions:
- Preparation and strategic planning are paramount for RRT programs facing pandemic-induced surges.
- Ensuring adequate resources and flexible operational models are key to maintaining essential nephrology services during public health crises.
- Disaster response plans must address personnel, supplies, equipment, and novel therapeutic approaches to manage AKI during widespread outbreaks.
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