Controversies in Clinical Nephrology: Optimizing renal replacement therapy deliverables through multidisciplinary work in the intensive care unit.
Controversies in Clinical Nephrology: Optimizing renal replacement therapy deliverables through multidisciplinary work in the intensive care unit.
Clin Nephrol. 2018 Apr 10;:
Authors: Neyra JA, Goldstein SL
Abstract
Two essential elements to provide effective RRT to critically ill patients with AKI in the ICU are: 1) the multidisciplinary interplay among intensivists, nephrologists, pharmacists, nurses, nutritionists, and other key members of the acute-care team for personalized therapy (i.e., RRT candidacy, timing of RRT initiation, RRT goals for solute control, RRT goals for fluid removal/regulation, renal recovery evaluation, RRT de-escalation, etc.) and 2) the iterative assessment and adjustment of RRT goals according to the clinical status of the patient. Therefore, the vehicle for effective RRT in the ICU requires optimal channels of communication among all members of the acute-care team and the systematic monitoring of the clinical status of the patient and RRT-specific goals (prescribed and delivered). Several tools such as customized flowsheets in the electronic health record (EHR) and static and functional tests or point-of-care ultrasonography (POCUS) to assess hemodynamic status, heart function, and intravascular volume assessment can be employed for this purpose.
PMID: 29633700 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Neyra JA, Goldstein SL Tags: Clin Nephrol Source Type: research
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