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Management of renal replacement therapy in ICU patients: an international survey

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Abstract

Purpose

The optimal management of renal replacement therapy (RRT) in critically ill patients remains a matter of debate, although insights have arisen from recent large trials. Nonetheless, little is known about the current practices and beliefs of intensivists. The goal of this study was to record current practices in RRT management among an international panel of intensivists.

Methods

An online questionnaire that included questions about RRT management in critically ill patients with acute kidney injury was sent to European Society of Intensive Care Medicine members in 2010.

Results

Two hundred and seventy-three intensivists from 50 countries responded. The respondents had an average of 12 (7–20) years of experience in ICUs, and most of them worked in mixed ICUs. Most of the intensivists were responsible for prescribing RRT (92.6 %). Half of the respondents reported using both intermittent haemodialysis and continuous renal replacement therapy techniques (CRRT), but most preferred using CRRT. The reasons for preferring CRRT were the perception of better haemodynamic stability, better therapeutic effect resulting from cytokine removal and easier fluid balance control. The intensivists used higher RRT doses in septic patients than in non-septic patients (p = 0.03). Finally, we observed an increasing inclination towards the early use of RRT among the intensivists.

Conclusion

CRRT remains the preferred technique for most intensivists in Europe, and a large proportion of the participating intensivists used RRT prescription doses similar to those proposed a decade ago. Our results provide insights into the motivations of intensivists while presenting the technique that may help in selecting control groups for future trials.

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Acknowledgments

This study was endorsed by the European Critical Care Research Network.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care and SAMU, Lariboisière Hospital, Assistance Publique-Hopitaux de Paris, University of Paris 7 Denis Diderot, 2 rue Ambroise-Paré, 75475, Paris Cedex 10, France

    Matthieu Legrand & Didier Payen

  2. University Paris Diderot, EA-3509, 75475, Paris, France

    Matthieu Legrand & Didier Payen

  3. Medical-Surgical Intensive Care Unit, Saint-Etienne University Hospital, Saint-Etienne, France

    Michael Darmon

  4. Jan Monnet Medical School, Saint-Etienne University, Saint-Etienne, France

    Michael Darmon

  5. Medical Intensive Care Unit, Innsbruck Medical University, Innsbruck, Austria

    Michael Joannidis

Authors
  1. Matthieu Legrand
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  2. Michael Darmon
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  3. Michael Joannidis
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  4. Didier Payen
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Corresponding author

Correspondence to Matthieu Legrand.

Additional information

For the European Critical Care Research Network.

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Legrand, M., Darmon, M., Joannidis, M. et al. Management of renal replacement therapy in ICU patients: an international survey. Intensive Care Med 39, 101–108 (2013). https://doi.org/10.1007/s00134-012-2706-x

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  • DOI: https://doi.org/10.1007/s00134-012-2706-x

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