Continuous Renal Replacement Therapy

Second Edition

Edited by John A. Kellum, Rinaldo Bellomo, Claudio Ronco, and Series edited by John A. Kellum

Pittsburgh Critical Care Medicine

Evidence-based practical guidelines with key studies and trials listed in each chapter
Edited by internationally recognized leaders in CRRT
Quick reference answers to situations encountered in daily practice

New to this Edition:

New chapter on the use of biomarkers to aid in patient selection and timing
Extensive revisions on terminology and nomenclature to match current standards
The most up-to-date information on newly developed CRRT machines

Continuous Renal Replacement Therapy

Second Edition

Edited by John A. Kellum, Rinaldo Bellomo, Claudio Ronco, and Series edited by John A. Kellum

Pittsburgh Critical Care Medicine

Description

Continuous Renal Replacement Therapy (CRRT) is the standard of care for management of critically ill patients with acute renal failure. Part of the Pittsburgh Critical Care series, Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance about this treatment modality, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice. Organized into sections on theory, practice, special situations, and organizational issues, this volume provides a complete view of CRRT theory and practice. Tables summarize and highlight key points, and key studies and trials are included in each chapter. The second edition has been updated to include a new chapter on the use of biomarkers to aid in patient selection and timing, extensive revisions on terminology and nomenclature to match current standards, and the most up-to-date information on newly developed CRRT machines.

Continuous Renal Replacement Therapy

Second Edition

Edited by John A. Kellum, Rinaldo Bellomo, Claudio Ronco, and Series edited by John A. Kellum

Pittsburgh Critical Care Medicine

Part 1: Theory

Chapter 1
The Critically Ill Patient with Acute Kidney Injury
Aditya Uppalapati and John A. Kellum

Chapter 2
History and Rationale for CRRT
Ilona Bobek and Claudio Ronco

Chapter 3
Nomenclature for Renal Replacement Therapy in Acute Kidney Injury
Mauro Neri, Jorge Cerda, Francesco Garzotto, Gianluca Villa, and Claudio Ronco

Chapter 4
Basic Principles of Solute Transport
Zhongping Huang, Jeffrey J. Letteri, Claudio Ronco, and William R. Clark

Chapter 5
Principles of Fluid Management in the ICU
Rinaldo Bellomo and Sean M. Bagshaw

Chapter 6
Indications, Timing, and Patient Selection
John A. Kellum, Raghavan Murugan, and Mitra Nadim

Chapter 7
Biomarkers for Initiation of Renal Replacement Therapy
Alexander Zarbock and Lakhmir S. Chawla

Chapter 8
Extended Indications
Rinaldo Bellomo and Ian Baldwin

Chapter 9
Dose Adequacy and Assessment
Zaccaria Ricci and Claudio Ronco

Chapter 10
Acid-base and Electrolyte Disorders
John A. Kellum

Part 2: Practice

Chapter 11
Choosing a Renal Replacement Therapy in Acute Kidney Injury
Jorge Cerdá and Claudio Ronco

Chapter 12
Vascular Access for Continuous Renal Replacement Therapy
Alexander Zarbock and Kai Singbart

Chapter 13
The Circuit and the Prescription
Rinaldo Bellomo and Ian Baldwin

Chapter 14
The Membrane: Size and Material
Zhongping Huang, Jeffrey J. Letteri, Claudio Ronco, and William R. Clark

Chapter 15
Fluids for Continuous Renal Replacement Therapy
Paul M. Palevsky and John A. Kellum

Chapter 16
Alarms and Troubleshooting
Zaccaria Ricci, Ian Baldwin, and Claudio Ronco

Chapter 17
Non Anticoagulation Strategies to Optimise Circuit Function in RRT
Ian Baldwin

Chapter 18
Anticoagulation
Rinaldo Bellomo and Ian Baldwin

Chapter 19
Regional Citrate Anticoagulation
Nigel Fealy

Chapter 20
Drug Dosing in Continuous Renal Replacement Therapy
Adrian Wong, Sandra L. Kane-Gill, and John A. Kellum

Part 3: Special Situations

Chapter 21
Renal Replacement Therapy in Children
Michael L. Moritz

Chapter 22
Therapeutic Plasma Exchange in Critical Care Medicine
Joseph E. Kiss

Chapter 23
MARS: Molecular Adsorbent Recirculating System
Nigel Fealy and Rinaldo Bellomo

Chapter 24
Sorbents
Dehua Gong and Claudio Ronco

Chapter 25
Hybrid Therapies
Dinna N. Cruz and Claudio Ronco

Part 4: Organizational Issues

Chapter 26
The ICU Environment
Ayan Sen

Chapter 27
Patient Care Quality and Teamwork
Kimberly Whiteman and Frederick J. Tasota
Chapter 28
Organizational Aspects: Developing Policies and Procedures for Continuous Renal Replacement Therapies (CRRT)
Jorge Cerdá

Chapter 29
Documentation, Billing, and Reimbursement for Continuous Renal Replacement Therapy
Kevin W. Finkel

Chapter 30
Machines for CRRT
Lakhmir S. Chawla and Claudio Ronco

Chapter 31
Quality Improvement for Continuous Renal Replacement Therapies
Ian Baldwin and Rinaldo Bellomo

Chapter 32
Educational Resources
Ian Baldwin and Kimberly Whiteman

Continuous Renal Replacement Therapy

Second Edition

Edited by John A. Kellum, Rinaldo Bellomo, Claudio Ronco, and Series edited by John A. Kellum

Pittsburgh Critical Care Medicine

Author Information

John A. Kellum is a Professor and Vice Chair of the Department of Critical Care Medicine at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania. Rinaldo Bellomo is a Professor of Medicine and Director of Intensive Care Research at Melbourne University in Melbourne, Australia. Claudio Ronco is a Professor of Clinical Nephrology and Medicine and Director of the Department of Nephrology at St. Bortolo Hospital in Vicenza, Italy.

Contributors:

Sean M. Bagshaw, MD, MSc
Faculty of Medicine and Dentistry
Division of Critical Care Medicine
University of Alberta
Edmonton, Canada

Ian Baldwin, RN, PhD
Adjunct Professor
Deakin and RMIT Universities
Austin Health
Melbourne, Australia

Ilona Bobek, PhD
Budapest, Hungary

Jorge Cerdá, MD, MS, FACP, FASN
Clinical Professor of Medicine
Department of Medicine
Albany Medical College
Albany, New York

Lakhmir S. Chawla, MD
Associate Professor of Medicine
Department of Medicine
Veterans Affairs Medical Center
Washington, District of Columbia

William R. Clark, MD
Senior Medical Director
Renal Medical Affairs
Baxter Healthcare Corporation
Deerfield, Illinois

Dinna N. Cruz, MD, MPH
Department of Nephrology
Dialysis and Transplantation
Ospedale San Bortolo
International Renal Research Institute Vicenza
Vicenza, Italy

Nigel Fealy, RN, MN, ACCCN
Department of Intensive Care
Austin Hospital
Melbourne, Australia

Kevin W. Finkel, MD, FACP, FASN, FCCM
Professor and Director of Renal Diseases and Hypertension
University of Texas Health Science Center
Houston Medical School
Houston, Texas

Francesco Garzotto, PhD
San Bortolo Hospital
Department of Nephrology
Dialysis and Transplantation
International Renal Research Institute of Vicenza
Vicenza, Italy

Dehua Gong, MD
Research Institute of Nephrology
Jinling Hospital
Nanjing University
Nanjing, China

Zhongping Huang, PhD
Department of Mechanical Engineering
Widener University
Chester, Pennsylvania

Sandra L. Kane-Gill, PharmD, MSc, FCCP, FCCM
Associate Professor of Pharmacy and Therapeutics
Faculty, School of Pharmacy
Center for Critical Care Nephrology
University of Pittsburgh
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania

Joseph E. Kiss, MD
Institute for Transfusion Medicine
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania

Jeffery J. Letteri, BS
Director
Baxter Healthcare Renal Division
Nantucket, Massachusetts

Michael L. Moritz, MD
Division of Nephrology
Department of Pediatrics
Children's Hospital of Pittsburgh
The University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania

Raghavan Murugan, MD, MS, FRCP
Associate Professor of Critical Care Medicine and Clinical and Translational Science
Department of Critical Care Medicine
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania

Mitra Nadim, MD
Department of Medicine
University of Southern California
Los Angeles, California

Mauro Neri
International Renal Research Institute of Vicenza
San Bortolo Hospital
Vicenza, Italy

Paul M. Palevsky, MD
Chief of Renal Section
VA Pittsburgh Healthcare System
Professor of Medicine and Clinical and Translational Science
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania

Zaccaria Ricci, MD
Pediatric Cardiac Intensive Care Unit
Department of Pediatric Cardiac Surgery
Bambino Gesù Children's Hospital, IRCCS
Rome, Italy

Ayan Sen, MD, MSc, FACEP, FCCP
Consultant and Assistant Professor of Critical Care and Emergency Medicine
Mayo Clinic
Phoenix, Arizona

Kai Singbartl, MB, ChB, PhD, FRCA, FFA(SA)
Department of Anesthesiology
Penn State College of Medicine
Hershey, Pennsylvania

Frederick Tasota, RN, MSN
UPMC Presbyterian
Pittsburgh, Pennsylvania

Aditya Uppalapati, MD
Department of Medicine
Saint Louis University
Saint Louis, Missouri

Gianluca Villa, MD
International Renal Research Institute of Vicenza
San Bortolo Hospital
Vicenza, Italy
Department of Health Sciences
Section of Anesthesiology
University of Florence
Florence, Italy

Kimberly Whiteman, DNP, RN
Assistant Professor of Nursing
Co-Director Graduate and Professional Studies Nursing Programs
Waynesburg University
Pittsburgh, Pennsylvania

Adrian Wong, PharmD
Resident
University of Pittsburgh School of Pharmacy
Pittsburgh, Pennsylvania

Alexander Zarbock, MD
Department of Anaesthesiology
Intensive Care and Pain Medicine
University Hospital Münster
Münster, Germany

Continuous Renal Replacement Therapy

Second Edition

Edited by John A. Kellum, Rinaldo Bellomo, Claudio Ronco, and Series edited by John A. Kellum

Pittsburgh Critical Care Medicine

Reviews and Awards

"The real success of this book is that it is the most complete yet concise reference book available on this important and ever-more present therapy. Moreover, it takes complex topics and makes them accessible to clinicians who are at the beginning of their training, but manages to add new layers of information for the more seasoned physicians." -International Anesthesia Research Society