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Published byMartha Nelson Modified over 9 years ago
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Renal Replacement Therapy in Intensive Care Units
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Absolute Indications of RRT in AKI (Renal Replacement Therapy) Refractory fluid overload Refractory hyperkalemia (K>6.5 meq/L) Uremic pericarditis, encephalopathy Refractory metabolic acidosis (pH < 7.1) Overdose with a dialyzable toxin/drug
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Relative Indications of RRT in AKI (Renal Replacement Therapy ) Azotemia (urea > 80~100 mg/dL) Oliguria (urine output<200 ml/12 hr) Anuria/extreme oliguria (urine output<50 ml/12 hr) [ p.s. after proper correction of pre-renal & post-renal factors ]
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Specialized Condition in Renal Replacement Therapy Post cardiac surgery refractory oliguria in first 8 hrs Tumor lysis syndrome Oliguria Persistent hyperphosphatemia Persistent hyperuricemia Persistently low calcium levels
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Unstable Hemodynamic Status Require High-dose Vasopressor in AKI - Dopamine > 20 mcg/kg/min - Norepinephrine > 0.3 mcg/kg/min and/or Absolute indications of RRT in AKI Relative Indications of RRT in AKI Specialized condition - post cardiac surgery - tumor lysis syndrome Proposed Indications for Continuous renal replacement therapy (CVVH, CVVHD, CVVHDF)
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