1/20 SLED

#CRRT and #IHD are different treatments, we know now

But, Is there something in between?

✅YES & it´s called...
🤔Wait, whats the name?

#SLED? #PIRRT? #HYBRID? #SHIFT? #AVVH?

💥Lets review this confusing & amazing topic
#tweetorial 2/20

When giving RRT to critical ill patients with AKI #CRRT & #iHD have different advantages

#CRRT
✅Hemodynamic stability
✅Gentle solute removal
✅Steady state similar to kidney

#iHD
✅Lower Cost
✅Machine free time
✅Equipment almost always available

1/ SECOND tweetorial in the CRRT SERIES

⚡️DOSE assessment in CRRT
⚡️Formation of “effluent” (E)
⚡️Modalities

Retweet if you like

To read the FIRST thread 👇

https://twitter.com/adequator_app/status/1209108776944619520?s=21

2/ Assessment of RRT dose in AKI

🤨Critical and AKI patients have characteristics that make RRT dose assessment challenging

✔️Constant change in volume status
✔️Unsteady metabolic state (catabolism, nutrition, inflammation)
✔️Modality options (H, HD, HDF, HDI, SLED)

1/16
Conventional Hemodialisis (HD)and continuous therapies (CRRT) both have blood pumps, filters, use catheters and are used in renal failure

But they are completely different treatments

Wonder Why? 👇🧵 get your calculator 2/ First we have to remember the concept of:

CLEARANCE (K)=Ratio of mass removal rate (N) to blood solute concentration (CB)

K= N/CB

✅ Practical definition: Volume of plasma completely cleaned from (X)

for this tweetorial (X) represent small molecules 40-100 daltons

Regional Citrate Anticoagulation (RCA) for CRRT

Prescription with the ADEQUATOR adequatorapp.com
And some Rationale

#CRRT #AKI #nephrology #citrate #adequator
@luck_urine

Follow the Thread 1/10 RATIONALE OF RCA

Forms Ci-Ca complexes--> i Ca drops --> coagulation stops

1. NO bleeding
2. Better circuit life
3. KDIGO -> Citrate for everyone
4. Complex protocols
5. Adequator help us

📈CRRT 📉

📝Prescription 📝
&
🔮Prediction of Delivered Dose🔮

Using the ADEQUATOR

#CRRT #nephrology #AKI #criticalnephrology @RenalFellowNtwk @adequator_app 2/8👨🏽‍💼Male 50 years old needs CRRT for volume control and AKI

- 100 kg, 170 cm height, Htct 35%

- Modality CVVHDF
- Prescribed dose 25 ml/kg/hr
- Anticoagulation: none
- Institution down time average: 2 hours
- Urea cl dose based, so we use SC of 1