Table 2. CKRT Prescription Characteristics.
| Characteristic | Total responses, No. (%) |
|---|---|
| Clinical scenario in which the physician would commence CKRTa | |
| No. | 91 |
| Severe hyperkalemia | 82 (90) |
| Treating fluid overload in a child with critical illness | 77 (85) |
| Hyperammonemia | 77 (85) |
| Persistent refractory metabolic acidosis | 54 (59) |
| Removing soluble mediators of septic shock | 18 (20) |
| Preventing fluid overload in a child with critical illness | 16 (18) |
| Creating space for nutrition by allowing liberalization of intake | 10 (11) |
| Preferred KRT modality for hyperammonemia | |
| No. | 123 |
| CVVHDF | 63 (51) |
| CVVHD | 38 (31) |
| CVVH | 14 (11) |
| IHD | 7 (6) |
| PD | 1 (1) |
| Dialysate or effluent dose, median (IQR), mL/kg/h | |
| In neonates | 35 (30-50) |
| In children | 30 (30-40) |
| Blood flow rate, median (IQR), mL/min | |
| Minimum | 20 (10-20) |
| Maximum | 200 (150-200) |
| Solutions used for circuit priming, excluding blooda | |
| No. | 126 |
| Normal saline | 84 (67) |
| Human albumin solution | 59 (47) |
| Plasmalyte | 17 (14) |
| Hartmann solution | 8 (6) |
| Fresh frozen plasma | 7 (6) |
| Indications for blood priming of the circuita | |
| No. | 121 |
| Weight <10 kg | 68 (56) |
| Hemodynamic instability or inotropic requirement | 57 (47) |
| Extracorporeal volume >10% of circulating blood volume | 48 (40) |
| Anemia | 45 (37) |
| Never used | 19 (16) |
| Blood priming performed in all patients receiving CKRT | 2 (2) |
| Modality of blood priming | |
| No. | 128 |
| Priming the whole CKRT circuit with blood | 50 (39) |
| Combining blood and crystalloids for a normal hematocrit | 38 (30) |
| Administering a blood transfusion before starting CKRT | 21 (16) |
| Priming the whole CKRT circuit with blood, or administering a blood transfusion | 4 (3) |
| Combining blood and colloids for a normal hematocrit | 2 (2) |
| Otherb | 1 (1) |
| Never performed | 12 (10) |
| Preferred dialysate solution | |
| No. | 147 |
| Bicarbonate base solution | 107 (73) |
| Lactate base solution | 40 (27) |
| Customization of the dialysate bag (eg, adding glucose or sodium) | |
| No. | 137 |
| With customization | 69 (50) |
| Position of the replacement fluid | |
| No. | 130 |
| Combination of predilution and postdilution | 46 (35) |
| Postdilution | 29 (22) |
| Predilution | 29 (22) |
| Variable practice depending on patient scenario | 26 (20) |
| Filtration-to-dialysis ratio during CVVHDF | |
| No. | 111 |
| 50/50 | 45 (41) |
| 30/70 | 35 (32) |
| Dependent on molecular weight of the target solute | 31 (28) |
| Diuretics (eg, furosemide) during CKRT | |
| No. | 126 |
| Used diuretics | 49 (39) |
| Nutrition support changes during CKRTa | |
| No. | 130 |
| Change in protein | 62 (48) |
| Change in calories | 49 (38) |
| Change in trace elements | 40 (31) |
| No changes | 52 (40) |
Abbreviation: CKRT, continuous kidney replacement therapy; CVVH, continuous venovenous hemofiltration; CVVHD, continuous venovenous hemodialysis; CVVHDF, continuous venovenous hemodiafiltration; IHD, intermittent hemodialysis; PD, peritoneal dialysis.
a
The sum of percentages is more than 100% because respondents could indicate more than 1 option.
b
Priming the whole circuit first with crystalloid and then blood prime.