Dashboards to Facilitate Nephrology Disaster Planning in the COVID-19 Era

Stevens, Jacob S.; Toma, Katherine; Tanzi-Pfeifer, Susan; Rao, Maya K.; Mohan, Sumit; Gharavi, Ali G.

doi:10.1016/j.ekir.2020.06.033

Cited by 11 publications

(14 citation statements)

References 5 publications

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“…Partially used fluid bags at the end of the therapy were discarded, adding to the critical shortage of treatment fluids. We developed a nomogram to avoid discarded bags is described in detail in a previous publication (5). e. Anti-coagulation Protocol: A significant proportion of our COVID-19 patients were experiencing multiple clotting episodes while on CRRT despite therapeutic doses of systemic heparin.…”

Section: Crrt Optimization Strategies a Use Of Prolonged Intermittenmentioning

confidence: 99%

“…We previously described the strategies to deal with the surge at one of our hospitals ( 4 , 5 ). We now address the tactics employed throughout our hospital network-The New York-Presbyterian (NYP) hospital system.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Optimizing Kidney Replacement Therapy During the COVID-19 Pandemic Across a Complex Healthcare System

et al. 2020

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The unprecedented surge of nephrology inpatients needing kidney replacement therapy placed hospital systems under extreme stress during the COVID-19 pandemic. In this article, we describe the formation of a cross campus “New-York Presbyterian COVID-19 Kidney Replacement Therapy Task Force” with intercampus physician, nursing, and supply chain representation. We describe several strategies including the development of novel dashboards to track supply/demand of resources, urgent start peritoneal dialysis, in-house preparation of kidney replacement fluid, the use of unconventional personnel resources to ensure the safe and continued provision of kidney replacement therapy in the face of the unanticipated surge. These approaches facilitated equitable sharing of resources across a complex healthcare-system and allowed for the rapid implementation of standardized protocols at each hospital.

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Section: Crrt Optimization Strategies a Use Of Prolonged Intermittenmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Optimizing Kidney Replacement Therapy During the COVID-19 Pandemic Across a Complex Healthcare System

et al. 2020

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“…In the midst of a surge of patients, this led to an unprecedented number of patients with AKI and need for CRRT. 2 The increased demand was met with a rapid procurement of additional machines and the use of novel sharing protocols which allowed us to provide RRT to twice the number of patients that we would have otherwise been able to accomodate 4 .…”

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confidence: 99%

“…Attach the dialysate outflow (blue) Hansen to the dialyzer at one end while partially capping the dialysate outflow port on the polysulfone dialyzer. 4. Capping the outflow port on the filter tightly will force the dialysate to cross the membrane on to the blood side of the filter and flow out from the bloodline connection ports.…”

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confidence: 99%

Protocol for Local On-Site Dialysate Production for Continuous Renal Replacement Therapy during the COVID-19 Pandemic

et al. 2021

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Acute kidney injury frequently occurs in patients with COVID-19 and injury severe enough to require renal replacement therapy (RRT) is a common complication among critically-ill patients.[1-3] During the surge, there was a high demand for dialysate for continuous RRT, and this increase in demand coupled with vulnerabilities in the supply chain necessitated alternative approaches, including internal production of dialysate. Using a standard hemodialysis machine and off the shelf supplies as per Federal Drug Administration (FDA) guidelines, we developed a method for on-site dialysate production that is adaptable and can be used to fill multiple bags at once. The use of a central reverse osmosis unit, dedicated hemodialysis machine, sterile bags with separate ports for fill and use, and frequent testing will ensure stability, sterility and therefore safety of produced dialysate. Dialysate made in house was tested and showed both stability and sterility for at least 30 hours. This detailed description of our process for generating dialysate can serve as a guide for other programs experiencing similar vulnerabilities in the demand vs. supply of dialysate.

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Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

et al. 2022

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The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected patients with kidney disease, causing significant challenges in disease management, kidney research and trainee education. For patients, increased infection risk and disease severity, often complicated by acute kidney injury, have contributed to high mortality. Clinicians were faced with high clinical demands, resource shortages and novel ethical dilemmas in providing patient care. In this review, we address the impact of COVID-19 on the entire spectrum of kidney care, including acute kidney injury, chronic kidney disease, dialysis and transplantation, trainee education, disparities in health care, changes in health care policies, moral distress and the patient perspective. Based on current evidence, we provide a framework for the management and support of patients with kidney disease, infection mitigation strategies, resource allocation and support systems for the nephrology workforce.

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Dashboards to Facilitate Nephrology Disaster Planning in the COVID-19 Era

Cited by 11 publications

References 5 publications

Optimizing Kidney Replacement Therapy During the COVID-19 Pandemic Across a Complex Healthcare System

Optimizing Kidney Replacement Therapy During the COVID-19 Pandemic Across a Complex Healthcare System

Protocol for Local On-Site Dialysate Production for Continuous Renal Replacement Therapy during the COVID-19 Pandemic

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions

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