Dynamic CRRT Prescription for Complicated Critically Ill Patient: A Case Report

Continuous renal replacement therapies (CRRTs) and sequential extracorporeal blood purification (EBP) therapies can be used in patients with severe COVID-19 disease to support kidney failure and restore immune homeostasis. EBP prescription should be based on the patient’s clinical needs and frequent...

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Main Authors: Clemente Santorsola, Alberto Corona, Matteo Cecchi, Niccolò Castellani Nicolini, Elena Zendra, Alice Capone, Ivan Gatti, Matteo Brivio, Silvia Falsini, Gianluca Villa
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2024/1837150
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author Clemente Santorsola
Alberto Corona
Matteo Cecchi
Niccolò Castellani Nicolini
Elena Zendra
Alice Capone
Ivan Gatti
Matteo Brivio
Silvia Falsini
Gianluca Villa
author_facet Clemente Santorsola
Alberto Corona
Matteo Cecchi
Niccolò Castellani Nicolini
Elena Zendra
Alice Capone
Ivan Gatti
Matteo Brivio
Silvia Falsini
Gianluca Villa
author_sort Clemente Santorsola
collection DOAJ
description Continuous renal replacement therapies (CRRTs) and sequential extracorporeal blood purification (EBP) therapies can be used in patients with severe COVID-19 disease to support kidney failure and restore immune homeostasis. EBP prescription should be based on the patient’s clinical needs and frequently re-evaluated during the intensive care unit (ICU) stay. Personalization of treatment at the bedside plays a fundamental role for patient recovery. This aim can be simplified by using both clinical and molecular data collected from a patient-individualized web registry. In this case report, we describe how we apply a sequential approach to EBP therapies following the rapid evolution of a critically ill COVID-19 patient with acute kidney injury. We show patient strategies and outcomes using bedside data from a registry-based method for the routine use of EBP. We explain the choice of specific hemofilter prescription, also focusing on dose and anticoagulation strategies. We describe the difficulties, uncertainties, and mistakes made during EBP prescription. Furthermore, we discuss the causes and workable solutions that can be adopted by the ICU physician for a better EBP prescription, considering the current lack of well-recognized indications.
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spelling doaj-art-fb2fb87ca0304a4583497d1e1e172d662025-08-20T01:54:15ZengWileyCase Reports in Critical Care2090-64392024-01-01202410.1155/2024/1837150Dynamic CRRT Prescription for Complicated Critically Ill Patient: A Case ReportClemente Santorsola0Alberto Corona1Matteo Cecchi2Niccolò Castellani Nicolini3Elena Zendra4Alice Capone5Ivan Gatti6Matteo Brivio7Silvia Falsini8Gianluca Villa9Accident and Emergency Department and Anesthesia and Intensive Care Medicine DepartmentAccident and Emergency Department and Anesthesia and Intensive Care Medicine DepartmentDepartment of Health SciencesDepartment of AnesthesiaDepartment of AnesthesiaDepartment of AnesthesiaAccident and Emergency Department and Anesthesia and Intensive Care Medicine DepartmentAnesthesia and Cardiac Intensive CareDepartment of Health SciencesDepartment of Health SciencesContinuous renal replacement therapies (CRRTs) and sequential extracorporeal blood purification (EBP) therapies can be used in patients with severe COVID-19 disease to support kidney failure and restore immune homeostasis. EBP prescription should be based on the patient’s clinical needs and frequently re-evaluated during the intensive care unit (ICU) stay. Personalization of treatment at the bedside plays a fundamental role for patient recovery. This aim can be simplified by using both clinical and molecular data collected from a patient-individualized web registry. In this case report, we describe how we apply a sequential approach to EBP therapies following the rapid evolution of a critically ill COVID-19 patient with acute kidney injury. We show patient strategies and outcomes using bedside data from a registry-based method for the routine use of EBP. We explain the choice of specific hemofilter prescription, also focusing on dose and anticoagulation strategies. We describe the difficulties, uncertainties, and mistakes made during EBP prescription. Furthermore, we discuss the causes and workable solutions that can be adopted by the ICU physician for a better EBP prescription, considering the current lack of well-recognized indications.http://dx.doi.org/10.1155/2024/1837150
spellingShingle Clemente Santorsola
Alberto Corona
Matteo Cecchi
Niccolò Castellani Nicolini
Elena Zendra
Alice Capone
Ivan Gatti
Matteo Brivio
Silvia Falsini
Gianluca Villa
Dynamic CRRT Prescription for Complicated Critically Ill Patient: A Case Report
Case Reports in Critical Care
title Dynamic CRRT Prescription for Complicated Critically Ill Patient: A Case Report
title_full Dynamic CRRT Prescription for Complicated Critically Ill Patient: A Case Report
title_fullStr Dynamic CRRT Prescription for Complicated Critically Ill Patient: A Case Report
title_full_unstemmed Dynamic CRRT Prescription for Complicated Critically Ill Patient: A Case Report
title_short Dynamic CRRT Prescription for Complicated Critically Ill Patient: A Case Report
title_sort dynamic crrt prescription for complicated critically ill patient a case report
url http://dx.doi.org/10.1155/2024/1837150
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