• Anaesthesia · Sep 2008

    Multicenter Study

    Renal replacement therapy for acute renal failure: a survey of practice in adult intensive care units in the United Kingdom.

    • J J Gatward, G J Gibbon, G Wrathall, and A Padkin.
    • Department of Anaesthesia, Royal United Hospital, Combe Park, Bath BA1 3NG, UK. jongatward@hotmail.com
    • Anaesthesia. 2008 Sep 1; 63 (9): 959-66.

    AbstractThis study surveyed current practice in adult intensive care units in the United Kingdom in three key areas of renal replacement therapy when used for acute renal failure: type of therapy used, typical treatment dose and anticoagulation. Responses were received from 303 (99%) of the 306 intensive care units. 269 units (89%) provide renal replacement therapy for acute renal failure. Most (65%) use continuous veno-venous haemofiltration as first-line therapy in the majority of patients, though continuous veno-venous haemodiafiltration is used by 31% of units. For haemofiltration, the median typical treatment dose (interquartile range [range]) is 32 ml.kg(-1).h(-1) (28.6-35.7 [14.3-85.7]), with 49% using a treatment dose of 35 ml.kg(-1).h(-1) or greater. For haemodiafiltration, the median typical treatment dose (interquartile range [range]) is 44 ml.kg(-1).h(-1) (28.6-57.1 [21.4-120.7]), with 67% using a treatment dose of 35 ml.kg(-1).h(-1) or greater. The vast majority of intensive care units use intravenous unfractionated heparin (96%) or epoprostenol (88%) for anticoagulation. Dosage and monitoring of these two agents vary markedly between units. No units use citrate anticoagulation. These results reveal a wide variety of practice in the delivery of renal replacement therapy between intensive care units in the United Kingdom.

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