Читать книгу 40 Years of Continuous Renal Replacement Therapy - Группа авторов - Страница 19

The effect of different modalities of CRRT on length of stay and recovery of renal function in the general population is still under evaluation since the case mix is changing in every study and the population treated is not homogeneous. In this field, further research is needed, although it has become evident that precision CRRT (personalized prescription) should be adopted in order to optimize results in single patients even in the absence of documented benefits of one specific technology for the general population. Adequate technological support becomes mandatory to fulfil all these expectations, and a generation of new machines and devices has been made compatible with the demand for increased efficiency, accuracy, safety, performance, and cost/benefit ratio. At present, almost all CRRT therapies can be delivered in a safe, adequate, and flexible way, thanks to devices being specifically designed for critically ill patients. The development is a point where multiple organ support therapy is envisaged as a possible therapeutic approach in the critical care setting. In this way, the CRRT machine becomes a platform for multiple organ support via extracorporeal therapies carried out with specific biomaterials and devices [28].

A last comment should be dedicated to the use of sorbents and especially those cartridges dedicated to the adsorption of endotoxin and related material. A great deal of evolution has occurred in this field and it seems we are gathering enough experience and evidence to suggest these therapies in specific patients with postsurgery abdominal septic shock [29, 30].

Fig. 1. Latest generation continuous RRT (CRRT) machines available on the market today.