Continuous renal replacement therapy in critical care unit: nurses’ role
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Abstract
Acute kidney injury (AKI) is a condition in which the kidneys stop functioning properly. It occurs in patients who are being treated in the intensive care unit. If the patient is not treated in time, serious complications can occur or even lead to death. Continuous renal replacement therapy (CRRT) is one of the most important treatments for critically ill patients with AKI. CRRT is usually used for renal support of critically ill patients with AKI, especially in hemodynamically unstable patients, in patients with volume overload due to a large amount of fluid and/or blood components and/or parenteral nutrition that cannot be treated with medications or regular hemodialysis, and in patients who have persistent metabolic acidosis. CRRT therapy carries a high risk and leads to serious complications. Critical care nurses (CCNs) are part of a care team that constantly use CRRT. They play a vital role in caring, monitoring, and preventing complications that may occur in patients. Therefore, this article aims to provide knowledge on the nursing care of patients receiving CRRT treatment on six issues including 1) mechanism of solution removal during CRRT, 2) modalities of CRRT, 3) indications, 4) cycle of CRRT system, 5) anticoagulants used during CRRT, and 6) a case study on the nursing care of patients with AKI receiving CRRT treatment. This article will help nurses better understand the principles of CRRT and effectively apply the knowledge to the care of patients with AKI receiving CRRT.
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บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวิทยาลัยพยาบาลบรมราชชนนี จังหวัดนนทบุรี
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับวิทยาลัยพยาบาลบรมราชชนนี จังหวัดนนทบุรี และคณาจารย์ท่านอื่น ในวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
References
Srisawat N, Tungsanga K. Acute kidney injury. Journal of the Department of Medical Services. 2017;42(6):64-8. (in Thai).
Siricheepchaiyan W. Incidence and etiology of acute kidney injury in hospitalized patients in department of medicine, Pranangklao hospital. Journal of Department of Health Service Support. 2021;17(2):51-60. (in Thai).
Yutintorn K, Jearnsujitwimol O. Mortality rate of septic and non-septic acute kidney injury patients requiring hemodialysis in ICU of Prapokklao hospital, Chanthaburi. The Journal of Prapokklao Hospital Clinical Medical Education Center. 2020;37(2): 115-24. (in Thai).
Hinkaew B. Nursing care of acute kidney disease: A case study. Thai Red Cross Nursing Journal. 2016;9(1):46-62. (in Thai).
Fayad AlI, Buamscha DG, Ciapponi A. Timing of renal replacement therapy initiation for acute kidney injury. Cochrane Database Syst Rev. 2018;12(12):CD010612. doi: 10.1002/14651858.CD010612.pub2.
Brain M, Winson E, Roodenburg O, McNeil J. Non anti-coagulant factors associated with filter life in continuous renal replacement therapy (CRRT): a systematic review and meta-analysis. BMC Nephrol. 2017;18(1):69. doi: 10.1186/s12882-017-0445-5.
Balouchi A, Parvizy S, Sharif Nia H. Ebadi A. Dialysis Adequacy among Haemodialysis Patients in Eastern Mediterranean Region: A Systematic Review and Meta-Analysis. Asia Pac. J. Health Manag. 2021;16(4):96-115. doi: 10.24083/apjhm.v16i4.1139
Cerda J, Ronco C. Modalities of continuous renal replacement therapy: technical and clinical considerations. Semin Dial. 2009;22(2):114-22. doi: 10.1111/j.1525-139X.2008.00549.x.
Srisawat N, Pirapornrattana S, Thiranathanakul K, Praditpornsilpa K, Tungsanga K, Eamong S. Textbook of CRRT. 1st ed. Bangkok: Text and general publication; 2018. (in Thai).
Pan HC, Chen YY, Tsai IJ, Shiao CC, Huang TM, Chan CK, et al. Accelerated versus standard initiation of renal replacement therapy for critically ill patients with acute kidney injury: a systematic review and meta-analysis of RCT studies. Crit Care. 2021; 25(1): 5. doi: 10.1186/s13054-020-03434-z.
The Nephrology Society of Thailand. 2018 Hemodialysis treatment and plasmapheresis guideline for kidney patients [Internet]. 2018 [cite 2021 Oct 19]; Available from: คู่มือการฟอกเลือด_e-book_final.pdf (nephrothai.org). (in Thai).
Lee HJ, Son YJ. Factors associated with in-hospital mortality after continuous renal replacement therapy for critically ill patients: A systematic review and meta-analysis. Int J Environ Res Public Health. 2020;17(23): 8781. doi: 10.3390/ijerph17238781.
Tsujimoto H, Tsujimoto Y, Nakata Y, Fujii T, Takahashi S, Akazawa M, et al. Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy. Cochrane Database Syst Rev. 2020;12(12):CD012467. doi: 10.1002/14651858.CD012467.pub3.
Liu C, Mao Z, Kang H, Hu J, Zhou F. Regional citrate versus heparin anticoagulation for continuous renal replacement therapy in critically ill patients: a meta-analysis with trial sequential analysis of randomized controlled trials. Crit Care. 2016;20(1):144. doi: 10.1186/s13054-016-1299-0.
Lumlertkul N, Srisawat N. How to run CRRT without Anticoagulant. Thai Journal of Critical Care Medicine. 2020;28(1):7-9. (in Thai).
Royal Thai Government Gazette. 2020 National drug information [Internet]. 2020 [cite 2021 Nov 20]; Available from: https:// dpf.mod.go.th/pdf/บัญชียาหลักแห่งชาติ พ.ศ.2563.aspx. (in Thai).
Davenport A, Tolwani A. Citrate anticoagulation for continuous renal replacement therapy (CRRT) in patients with acute kidney injury admitted to the intensive care unit. NDT Plus. 2009;2(6):439-47. doi: 10.1093/ ndtplus/sfp136.
Khuenkum B. Development clinical nursing practice guideline for acute kidney injury patients with continuous renal replacement therapy in medical intensive care unit Nakornping hospital, Chiang Mai Province. Journal of Nakornping Hospital. 2020;11(2): 64-86. (in Thai).
Mongkolsittikul W. The nursing care of chronic renal failure patients after hemodialysis: Case study 2 case. Mahasarakham Hospital Journal. 2018; 15(2):164-72. (in Thai).
