A Continuous Renal Replacement Therapy Protocol for Patients with Acute Kidney Injury in Intensive Care Unit with COVID-19

Journal of Clinical Medicine

卷:9

Federico Nalesso¹  Laura Gobbi¹  Lorenzo A. Calò¹  Laila Qassim¹  Leda Cattarin¹  Luca Sgarabotto¹  Ivo Tiberio²  Francesco Garzotto³ 

[1] Department of Medicine, Nephrology, Dialysis and Transplantation Unit, University of Padova, 35128 Padova, Italy;

[2] Emergency-Urgency Department, Anesthesia and Intensive Care, Azienda Ospedaliera di Padova University of Padova, 35128 Padova, Italy;

[3] Healthcare Directorate Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padova, Italy;

关键词: Covid-19;    AKI;    ARDS;    CRRT;    CVVHD;    HCO;   

DOI  :  10.3390/jcm9051529

来源: DOAJ

【 摘 要 】

COVID-19 often leads to acute respiratory distress syndrome complicated by acute kidney injury (AKI). The indications for renal replacement therapy for these patients are those commonly accepted to treat AKI. We describe a continuous veno-venous haemodialysis (CVVHD) protocol for AKI, which aims to provide the best treatment according to the particular patient’s and medical personnels’ needs in biohazard settings with limited human and technological resources. We designed a CVVHD protocol with a high cut-off (HCO) filter in regional citrate anticoagulation (RCA). The HCO filter in diffusion determines the enhanced cytokines clearance with less filter clotting due to a lower filtration fraction. In our hospital, at the beginning of the pandemic outbreak, we treated seven COVID-19 patients with AKI stage 2 and 3 and recorded the circuit lifespan and the number of interventions on monitors. CVVHD in RCA appears to be safe, effective and easy to be performed in a biohazard scenario using lower blood flows and less bag changes with fluid savings, a biohazard reduction and sparing of resources. Although the data come from a very small cohort, our protocol seems related to a low mortality.

【 授权许可】

Unknown