The Paediatric Intensive Care Masterclass covers Acute Kidney Injury (AKI) in children, emphasizing Renal Replacement Therapy in Critical Care. Explore etiology, diagnosis, and advanced management strategies in a concise, comprehensive module.

Continuous Kidney Replacement Therapy (CKRT) utilizes vascular access, a specialized membrane, and a circuit for renal support. Access options include central venous catheters or arteriovenous fistulas. The membrane, typically a high-flux filter, facilitates solute removal. The circuit involves a pump, filter, and tubing, maintaining a continuous flow for efficient blood purification in critical care settings.

Continuous Kidney Replacement Therapy (CKRT) modalities, prescriptions, and doses are tailored to individual patient needs. Modalities include Continuous Venovenous Hemofiltration (CVVH), Hemodiafiltration (CVVHDF), and Hemodialysis (CVVHD). Prescriptions specify parameters like fluid removal rates, replacement fluids, and anticoagulation. Doses are adjusted based on the patient's condition, with typical ranges for effluent flow (25-35 mL/kg/h) and duration (24/7 or intermittent). Precise adjustments ensure optimal renal support in critically ill patients.

In Continuous Renal Replacement Therapy (CRRT), the choice of anticoagulation is crucial to prevent circuit clotting. Options include systemic anticoagulation with heparin, regional citrate anticoagulation (RCA), or no anticoagulation (using a clotting filter). Heparin is common but poses bleeding risks. RCA is an alternative, binding calcium in the extracorporeal circuit. The choice depends on patient factors, contraindications, and the CRRT modality. Individualized decisions balance clot prevention and bleeding risk.

Optimize Continuous Renal Replacement Therapy (CRRT) circuit life: choose suitable anticoagulation, monitor parameters, select filters wisely, control blood flow, maintain aseptic technique, assess and adjust, and ensure expertise in the healthcare team.

Manage CKRT complications: address hypotension with fluid adjustments, handle electrolyte imbalances, control bleeding by modifying anticoagulation, address filter clotting promptly, combat infection with aseptic measures, and troubleshoot access issues for optimal outcomes.

Continuous Renal Replacement Therapy (CRRT) in liver failure helps manage complications like fluid overload and electrolyte imbalance, supporting hemodynamic stability. Adjustments in anticoagulation and fluid balance are crucial for optimal outcomes.

Renal Replacement Therapy (RRT) plays a vital role in managing metabolic disorders by addressing electrolyte imbalances and removing toxic metabolites. Tailored RRT strategies help maintain metabolic equilibrium, supporting patients with conditions like inborn errors of metabolism.

Continuous Renal Replacement Therapy (CRRT) in septic shock serves a crucial role by managing fluid balance, removing inflammatory mediators, and supporting hemodynamic stability. It aids in mitigating the impact of renal dysfunction in sepsis, contributing to improved patient outcomes.

Stop Continuous Renal Replacement Therapy (CRRT) when renal recovery occurs, hemodynamic stability is achieved, fluid balance is optimal, the underlying cause resolves, and overall clinical improvement aligns with patient preferences. Regular reassessment guides individualized decisions.

Adjust drug dosing in Continuous Kidney Replacement Therapy (CKRT) by considering drug properties, patient factors, and filter characteristics. Regular monitoring and dose titration are crucial for optimal therapeutic outcomes.

In Continuous Kidney Replacement Therapy (CKRT), tailor nutrition to meet metabolic needs. Monitor protein, caloric intake, and electrolytes. Individualize to optimize patient outcomes and support renal recovery.

Plasma exchange removes pathogenic substances from blood, treating autoimmune disorders, toxins, or organ failure. It involves separating plasma and replacing it with a substitute. Tailored to specific conditions, it aims for immune modulation and toxin removal.

In the Pediatric Intensive Care Unit (PICU), extra-corporeal tandem therapy combines techniques like ECMO and CRRT. It offers comprehensive cardiovascular and renal support for critically ill children, optimizing outcomes by addressing multi-system dysfunction.

Peritoneal Dialysis in the Pediatric Intensive Care Unit provides renal support by using the peritoneum as a natural filter. It's a gentle method suitable for critically ill children, aiding in fluid and toxin removal. Tailor the approach based on individual patient needs for optimal outcomes.

Intermittent hemodialysis in critically ill children offers renal support by intermittently filtering blood, managing fluid and electrolyte balance. Tailor the approach to individual patient needs for optimal outcomes in the Pediatric Intensive Care Unit.

In the medical industry, advanced toxin and cytokine removal filters are pivotal for extracorporeal therapies. These filters efficiently eliminate harmful substances, addressing systemic inflammation in conditions like sepsis. Continuous innovation in filter technology enhances their efficacy, contributing to improved patient outcomes and advancing critical care practices.