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CRRT in the Septic Patient

  • Matthew L. Paden
Chapter

Abstract

Acute kidney injury (AKI) is very common and has been associated with mortality in septic patients. Severe acidosis, hemodynamic instability, and fluid overload due to resuscitation fluids are often also seen in this population of patients. In this setting, reduction of renal function is often seen and continuous renal replacement therapy (CRRT) is often used as a bridge to support the patient through their septic acute kidney injury. The ultimate goal of this therapy is to allow recovery of native function. If this is not possible, then to provide renal function until stability improves sufficiently to convert to a form of renal replacement that can be managed as an outpatient. Little medical evidence exists surrounding the optimal way to provide CRRT to septic patients, much less children with sepsis. In this chapter, we will discuss the potential benefits and issues surrounding the use of CRRT during sepsis, and review the outcomes that have been seen when using this approach. We will also review CRRT’s role in using multiple extracorporeal organ support therapies for sepsis.

Keywords

Continuous renal replacement therapy Sepsis Septic shock Outcomes Extracorporeal membrane oxygenation Plasma exchange Extracorporeal life support 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Pediatric Critical CareEmory UniversityAtlantaUSA

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