Lmst

🫘Optimal time to stop continuous renal replacement therapy in children? Decision based on anticipated pathophysiology, underlying diagnoses, fluid balance & recovery of residual renal function (with increasing UO easily available sign, to date). Less CRRT may be more, but right time to cease still open question.
🔓https://rdcu.be/dKiC7

🫘 Refers to analysis on #CRRT in critically ill children & young adults.
#PedsICU #FOAMcc on @ICM
🔓 https://rdcu.be/dAs4w

Liberation from CRRT in critically ill children and young adults, analysis of the worldwide exploration of renal replacement outcomes collaborative in Kidney Disease Registry:
🔍 over 600 pts aged 0-25 years treated with #CRRT for #AKI or fluid balance disorders
💦 inability to liberate from CRRT common
🫘 several factors associated with successful liberation, including higher VIS & higher PELOD-2 score at CRRT initiation, higher UO prior to CRRT and shorter CRRT duration
🔓 https://rdcu.be/dAs4w

Concurrent renal replacement therapy & extracorporeal membrane oxygenation: what pediatric nephrologists need to know
🩸 #ECMO modalities & their usages
🔥 pathophysiology of inflammation during #ECLS
🫘 #AKI
💦 fluid overload
🩸 anticoagulation strategies in ECMO
🔄 therapeutic plasma exchange
🫘 indications & modalities of #CRRT
⚙️ technical aspects of implementing #RRT into the extracorporeal circuit
📊 outcomes associated with RRT in #PedsICU
#FOAMcc #FOAMecmo
🔓 https://rdcu.be/dzuG4

Outcomes in obese adults undergoing VV #ECMO, SR:
➡️ comparing patients with BMI of less than vs greater than or equal to 30, decreased mortality noted with obesity: may be protective??
➡️ with reports of multiple patients with with very high patients (≥ 80 & up to 93) surviving to discharge, morbid & super morbid obesity alone should no longer be considered contraindication to VV #ECLS
➡️ complications may be high: ⬆️ rates of #CRRT & thrombosis among obese patients
🖇️ https://bit.ly/46E0dPD

@jopo_dr dialytrauma occurs even with #CRRT but maybe not to the degree of iHD. IHD= planned “controlled” repetitive hypovolemic shock

Integrating cytokine adsorber post-dialyzer into #CRRT circuit in critically ill patients with liver failure, data from Cyto-SOLVE study showed decreased ammonia plasma-concentration but
🟤 no evidence for relevant ammonia-clearance by Cytosorb®
🟤 elimination mainly achieved by dialyzer (constant clearance over time depending on blood flow & effluent rate)
@ICM
🖇️ https://rdcu.be/c5scg

My plans for adventure today were thwarted by *hopefully* just spraining my foot while letting the dogs out.

I decided to finish my second in the ICU series. I’m less certain about my color choices here, but still learning.
#pyrography #MastoArt #ICU #CriticalCare #IntensiveCare #MedMastodon #CRRT

A 6”x6” basswood piece done with a woodburning and colored pencil. It depicts a man lying in a hospital bed, hooked up to a CRRT machine (continuous dialysis used in the ICU). The man and the bed have been colored shades of green, purple, and blue. The bed and sheets are also decorated with an angular pattern and polka dots, respectively. The lines running from him to the machine are red to depict his blood being cleaned by the CRRT machine. The machine is only faintly colored, largely through shading in the woodburning.

🟤 The few studies on #CRRT use in patients with acute liver failure have large limitations & focused mainly on its use if concomitant #AKI. CRRT membranes reduce ammonia levels and could be an adjunctive therapy, but could not be considered liver support or salvage therapy https://rdcu.be/c3X8z

🟤 In reply to https://rdcu.be/cZpbg

🟤 Refers to consensus statements for artificial liver support, in failure due to variable etiology, including graft failure after #Tx. https://rdcu.be/cU7s2

#CRRT practices in #WeRock in pediatrics https://link.springer.com/article/10.1007/s00467-022-05864-z.

Is #consensus on pediatric #CRRT practice patterns possible with the current evidence (or lack thereof?)
Our commentary to accompany pioneering work by #ESPNIC #CriticalCareNephrology group led by Dr Deep & Dr Demirkol
//jamanetwork.com/journals/jamanetworkopen/fullarticle/2799584?widget=personalizedcontent&previousarticle=2799580