Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

98
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
98
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

459
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
459
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

42
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
42
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

146
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
146
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

146
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
146
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

160
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
160

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Low dose of landiolol does not prevent postoperative atrial fibrillation after cardiac surgery in non-Asian patients. Comment on Br J Anaesth 2026; 136: 65-73.

British journal of anaesthesia·2026
Same author

Preoperative Exposure to Sodium-Glucose Cotransporter-2 Inhibitors and Acute Kidney Injury After Cardiac Surgery: A Retrospective Single-Centre Cohort Study With Overlap Weighting Propensity Score Analysis.

Heart, lung & circulation·2026
Same author

Passive leg raising, peripheral perfusion, and cardiac output: insights into hemodynamic coherence.

Critical care (London, England)·2026
Same author

Pro: we should fully utilise the preload reserve in high-risk patients undergoing noncardiac surgery.

European journal of anaesthesiology·2026
Same author

Interpreting circuit lifespan in the "E-CRRT" trial: considerations and limitations.

Intensive care medicine·2026
Same author

Hypoperfusion and cardiac surgery-associated major adverse kidney events: a single-center retrospective cohort study.

Anaesthesia, critical care & pain medicine·2026

Related Experiment Video

Updated: Aug 28, 2025

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
09:32

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge

Published on: January 20, 2023

3.6K

Refilling and preload dependence failed to predict cardiac index decrease during fluid removal with continuous renal

Matthias Jacquet-Lagrèze1,2,3, Martin Ruste4,5, William Fornier4

  • 1Department of Anesthesiology and Intensive Care, University Hospital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Lyon, France. matthias.jacquet-lagreze@chu-lyon.fr.

Journal of Nephrology
|September 19, 2022
PubMed
Summary
This summary is machine-generated.

Fluid removal is crucial for managing fluid overload. However, haemoconcentration and passive leg raising (PLR) did not reliably predict a decrease in cardiac index (CI) during mechanical fluid removal in critically ill patients.

Keywords:
Continuous renal replacement therapyFluid removalHaemoconcentrationPassive leg raisingRefilling

More Related Videos

Long-Term Continuous Measurement of Renal Blood Flow in Conscious Rats
05:09

Long-Term Continuous Measurement of Renal Blood Flow in Conscious Rats

Published on: February 8, 2022

2.7K
Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
07:59

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol

Published on: July 28, 2018

11.3K

Related Experiment Videos

Last Updated: Aug 28, 2025

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
09:32

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge

Published on: January 20, 2023

3.6K
Long-Term Continuous Measurement of Renal Blood Flow in Conscious Rats
05:09

Long-Term Continuous Measurement of Renal Blood Flow in Conscious Rats

Published on: February 8, 2022

2.7K
Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
07:59

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol

Published on: July 28, 2018

11.3K

Area of Science:

  • Critical care medicine
  • Nephrology
  • Hemodynamics

Background:

  • Fluid overload is a common complication after initial resuscitation in critically ill patients.
  • Mechanical fluid removal, often with continuous renal replacement therapy (CRRT), is used to manage fluid overload.
  • The Frank-Starling model suggests that fluid removal can decrease cardiac index (CI).

Purpose of the Study:

  • To investigate if haemoconcentration or passive leg raising (PLR) can predict a decrease in cardiac index (CI) during mechanical fluid removal.
  • To assess the diagnostic accuracy of plasma protein concentration variations in detecting a significant CI decrease during fluid removal.
  • To identify other potential predictive factors for CI changes during fluid removal.

Main Methods:

  • A single-centre prospective diagnostic accuracy study was conducted.
  • Sixty-nine adult patients undergoing mechanical fluid removal were included.
  • Plasma protein concentration, hemoglobin, CI during PLR, and transpulmonary thermodilution were measured before and after a 500 mL/hour fluid removal challenge.

Main Results:

  • Sixteen patients (23%) experienced a significant decrease in CI during fluid removal.
  • Haemoconcentration, assessed by plasma protein and hemoglobin levels, did not predict CI decrease.
  • Passive leg raising (PLR) and CI trending also failed to predict CI decrease.

Conclusions:

  • Haemoconcentration variables, preload dependence, and CI trending are unreliable predictors of CI decrease during mechanical fluid removal.
  • Further research is needed to identify reliable methods for predicting hemodynamic instability during fluid removal in critically ill patients.