Would you increase the delivered dose to more than 25 ml/kg/hr in a patient on CKRT if a prolonged interruption for a procedure is planned for the day?
Answer from: at Academic Institution
I often base my CRRT prescription not on weight but on serum electrolytes. I would increase the dose of CRRT if the patient is acidotic/hyperkalemic/etc. and decrease the dose if the phosphorus is low.
Guidelines, all guidelines have to be taken with a grain of salt. The Ronco CVVH trial found 35 ml/kg/hr was the goal, definitively. It was questioned because it was a single center with too many surgical patients. Is that really such a valid criticism? Not to be ignored, his study was pure post-dil...
Randomized trials have not demonstrated a benefit of high-dose CKRT vs lower-dose CKRT (20-25 ml/kg/hr). I typically prescribe a dose of 25-30 ml/kg/hr to give some cushion so that the delivered dose is at least 20-25 ml/kg/hr in the event of interruptions due to radiology studies, filter clotting, ...