Table 2.

Clinical practice for CRRT for COVID-19

Parameter	Clinical practice
Staff	Certified doctor of blood purification in critical care
	Certified doctor of infectious disease
	Experienced medical engineers
	Highly trained ICU nurses
Infection prevention and control	All staff who care for patient directly and handle CRRT equipment wear PPE: gloves, N95 mask, gown, cap, and face shield
	Patient is in an airborne infection isolation room at ICU, or designated ward
	CRRT equipment is placed in the anteroom during priming
Access	Temporary double-lumen catheter placed using ultrasound
CRRT modality	CRRT for initial treatment
	Consider transition to daytime RRT until recovery from AKI or can leave from biocontainment isolation
	PMMA or AN69ST membrane for initial hemofilter choice
Replacement solution	Self-admixture sodium bicarbonate and sodium chloride solution (Na+ 140 mEq/L, K+ 2.0 mEq/L, Ca2+ 1.0 mEq/L, Mg2+ 1.0 mEq/L, Cl− 113 mEq/L, CH3COO− 0.5 mEq/L, HCO3− 35 mEq/L, and glucose 100 mg/dL)
CRRT dosing	Deliver a total effluent dose of 20 mL/kg per hour
Anticoagulation	Nafamostat mesylate 30–40 mg per hour
Effluent disposal	Drain patient-contact effluent in the container and add a coagulant before disposal
	Wipe outside of the container with alcohol, then treated as hazardous waste, and dispose

ICU, intensive care unit; CRRT, continuous renal replacement therapy; PPE, personal protective equipment; AKI, acute kidney injury; PMMA, polymethyl methacrylate; AS69ST, polyethylenimine-coated polyacrylonitrile.