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a proposed algorithm for initiation of renal replacement therapy in adult critically ill patients的起始算法成人危重患者的肾脏替代治疗.pdf

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a proposed algorithm for initiation of renal replacement therapy in adult critically ill patients的起始算法成人危重患者的肾脏替代治疗

Available online /content/13/6/317 Viewpoint A proposed algorithm for initiation of renal replacement therapy in adult critically ill patients 1 2 1 2 Sean M Bagshaw *, Dinna N Cruz *, RT Noel Gibney and Claudio Ronco 1Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta T6G 2B7, Canada 2Department of Nephrology Dialysis and Transplantation and International Renal Research Institute Vicenza (IRRIV), San Bortolo Hospital, 36100 Vicenza, Italy *Contributed equally Corresponding author: Dinna N Cruz, dinnacruzmd@ Published: 11 November 2009 Critical Care 2009, 13:317 (doi:10.1186/cc8037) This article is online at /content/13/6/317 © 2009 BioMed Central Ltd Abstract specific factors and those related to organizational/logistical issues (Table 1). Indeed, studies have shown marked varia- Critically ill patients whose course is complicated by acute kidney injury often receive renal replacement therapy (RRT). For these tion of practice between clinicians, and across institutions patients, initiation of RRT results in a considerable escalation in and countries [7,8]. both the complexity and associated cost of care. While RRT is extensively used in clinical practice, there remains uncertainty An evaluation of timing of RRT initiation has been the focus of about the ideal circumstances of when to initiate RRT and for what