Perfusion-based deresuscitation during continuous renal replacement therapy: A before-after pilot study (The early dry Cohort)

Current management of fluid balance in critically ill patients with acute kidney injury: A scoping review

“…Overall, 22 studies involving 23,970 patients were included in the scoping review. [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] Two studies investigated fluid input, 17 , 19 17 studies investigated fluid removal, 18 , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , 36 , 37 and two studies examined a restrictive fluid protocol (RFP). 34 , 35 Five studies were conducted in a population not receiving RRT, 17 , [20] , [21] , [22] , 35 16 studies investigated AKI patients on RRT, 18 , 19 , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , 34 , [36] ...…”

“… 22 Of the included studies, eight were observational, 21 , 22 , [26] , [27] , [28] , 32 , 34 , 36 nine were interventional, 17 , 18 , 20 , 23 , 25 , 29 , 33 , 35 , 38 and five were post hoc analyses of interventional trials. 19 , 24 , 30 , 31 , 37 Ten of the studies were single centre, 17 , 18 , 21 , 23 , 26 , 28 , 29 , 32 , 34 , 36 and 12 were multicentre. 19 , 20 , 22 , 24 , 25 , 27 , 30 , 31 , 33 , 35 , 37 , 38 …”

Perspectives on peripheral perfusion assessment

“…Moreover, other promising uses of CRT have been reported during renal replacement therapy. Indeed, a pilot study in patients under continuous renal replacement therapy showed that a de-resuscitation protocol based on CRT and MS was associated with the achievement of a greater negative fluid balances without hemodynamic instability [51 ▪ ]. Meanwhile, in the SOCRATE study, a CRT >3 s before the initiation of intermittent hemodialysis was associated with an increased risk of intradialytic hemodynamic instability (RR, 2.6; 95% CI, 1.6–4.3; P = 0.0004) [52].…”

Fluid removal tolerance during the de-escalation phase: is preload unresponsiveness the best guiding candidate?

“…the normalization of tissue perfusion) [ 14 ] seems pertinent. Such a strategy, together with the application of a moderate and continuous UFnet, is feasible and leads to a more negative fluid balance at day 5 than usual practices [ 15 ]. Nevertheless, further studies are required to demonstrate the relevance of this approach on patient-centered outcomes.…”