Contributions to nephrology
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EBPTs represent a promising new approach to the adjuvant treatment of severe sepsis, septic shock and MODS. Their technology is rapidly evolving and pilot animal and human studies are now taking place to prepare the territory for the first large randomized controlled trial. ⋯ The correct technology and molecular targeting, however, are still being explored. Once the best technology has been determined, it is likely that phase II and phase III trials will be performed to test the hypothesis that these therapies can indeed alter mortality in severe inflammatory multiorgan dysfunction.
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Fluid management with CRRT requires an understanding of the principles of fluid removal and fluid balance. Although these appear to be similar to intermittent hemodialysis, there are significant differences. In order to utilize these techniques to their full ability, a variety of strategies can be used. No matter which method is used it is imperative that the goals for fluid management be well defined and monitoring for errors be a part of the protocol.