Forced fluid removal in critically ill patients with acute kidney injury
The aim was to test the feasibility of protocol‐driven fluid removal with continuous renal replacement therapy (CRRT) in patients in whom standard fluid balance prescription did not result in substantial negative fluid balances.
In 10 mechanically ventilated patients with sepsis or signs of inflammation and acute kidney injury [age 65 (48–78 years; median, range), simplified acute physiology score II 66 (39–116)], fluid removal was guided by mean arterial pressure (MAP), cardiac index (CI), mixed venous oxygen saturation (
Fluid removal rates during the 3 days before and during the study period [66 (36–72) h] were 11 (−30 to +36) ml/kg/day and −59 (−85 to −31) ml/kg/day, respectively (P = 0.002). In 12% of a total of 594 fluid removal rate evaluations, fluid removal had to be decreased or stopped. Most frequent reasons leading to decreasing fluid removal were (n, % of all instances, median lowest value from all patients):
In these patients, protocolized fluid removal with CRRT was associated with large negative fluid balances.
Document Type: Research Article
Publication date: 2012-10-01