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THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: Selection of Dialysate and Replacement Fluids and Management of Electrolyte and Acid-Base Disturbances

Authors


Address correspondence to: Michael A. Kraus, MD, 550 N University Blvd–UH1115, Indianapolis, IN 46202, or e-mail: mkraus@iupui.edu.

Abstract

Often, too little consideration is given to the fluids used in all forms of continuous renal replacement therapy (CRRT). However, errors in fluid prescription, delivery, or creation can be rapidly fatal; in addition, fluid associated expenses can be the overriding cost in continuous renal replacement therapies. While a standard solution is frequently acceptable in most clinical circumstances, specific electrolyte and acid-base disturbances may direct changes in fluid delivery and composition. Decisions regarding fluids, whether dialysate versus replacement, including generation and composition of therapy are discussed in this review.

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