Читать книгу 40 Years of Continuous Renal Replacement Therapy - Группа авторов - Страница 44

CRRT can achieve and maintain volume, electrolyte, acid-base, and uremic solute homeostasis among critically ill patients with AKI and multiorgan dysfunction. CRRT can facilitate additional therapeutic measures or reduce their potential for toxicity among patients who have poor tolerance due to AKI, such as provision of nutritional support, parenteral medications (including vital but nephrotoxic antimicrobials), blood transfusions, and other sources of “obligatory” fluid intake. CRRT can prevent overt complications of AKI. While CRRT can theoretically modulate inflammation and immune system function septic and other vasoplegic states, utilization of CRRT for this purpose remains uncertain. In the context of critical illness and multiorgan dysfunction, CRRT can provide an important platform to mitigate adverse kidney-organ (i.e., heart, lung, brain) interaction. Earlier CRRT initiation for these reasons is biologically plausible, clinically logical, and generally supported by observational data and small clinical trials (Table 2).