Tasty Morsels of Critical Care Tasty Morsels of Critical Care 035 | When to start CRRT
5 snips
Apr 5, 2021 Explore when is the best timing to start CRRT in critically ill patients, considering factors like volume overload and electrolyte imbalances. Learn about the furosemide stress test as a predictor for CRRT necessity and the complexities in determining the most beneficial timing for CRRT initiation in patients with AKI.
AI Snips
Chapters
Transcript
Episode notes
CRRT Indications Checklist
- Use CRRT for volume overload, refractory electrolytes (eg hyperkalaemia), severe acidosis, uremic complications, or dialyzable toxins.
- Consider temperature >40C as an additional indication.
Furosemide Stress Test Predicts CRRT Need
- Give 1–1.5 mg/kg IV furosemide and measure urine for two hours.
- If urine <200 mL, prepare to start CRRT; the test doesn't decide stopping CRRT.
Early CRRT Lacks Consistent Mortality Benefit
- Multiple RCTs (AKIKI, IDEAL-ICU, STARRT-AKI) show no mortality benefit for routine early CRRT.
- Many delayed groups (≈40–50%) never required CRRT.