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Survey of U.S. Critical Care Practitioners on Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Kidney Replacement Therapy
INTRODUCTION: The current prescription and practice of net ultrafiltration among critically ill patients receiving kidney replacement therapy in the U.S. are unclear. AIM OF THE STUDY: To assess the attitudes of U.S. critical care practitioners on net ultrafiltration (UF(NET)) prescription and pract...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Sciendo
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647664/ https://www.ncbi.nlm.nih.gov/pubmed/34934817 http://dx.doi.org/10.2478/jccm-2021-0034 |
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author | Chen, Huiwen Murugan, Raghavan |
author_facet | Chen, Huiwen Murugan, Raghavan |
author_sort | Chen, Huiwen |
collection | PubMed |
description | INTRODUCTION: The current prescription and practice of net ultrafiltration among critically ill patients receiving kidney replacement therapy in the U.S. are unclear. AIM OF THE STUDY: To assess the attitudes of U.S. critical care practitioners on net ultrafiltration (UF(NET)) prescription and practice among critically ill patients with acute kidney injury treated with kidney replacement therapy. METHODS: A secondary analysis was conducted of a multinational survey of intensivists, nephrologists, advanced practice providers, and ICU and dialysis nurses practising in the U.S. RESULTS: Of 1,569 respondents, 465 (29.6%) practitioners were from the U.S. Mainly were nurses and advanced practice providers (58%) and intensivists (38.2%). The median duration of practice was 8.7 (IQR, 4.2-19.4) years. Practitioners reported using continuous kidney replacement therapy (as the first modality in 60% (IQR 20%-90%) for UF(NET). It was found that there was a significant variation in assessment of prescribed-to-delivered dose of UF(NET), use of continuous kidney replacement therapy for UF(NET), methods used to achieve UF(NET), and assessment of net fluid balance during continuous kidney replacement therapy. There was also variation in interventions performed for managing hemodynamic instability, perceived barriers to UF(NET), belief that early and protocol-based fluid removal is beneficial, and willingness to enroll patients in a clinical trial. CONCLUSIONS: There was considerable practice variation in UF(NET) among critical care practitioners in the U.S., reflecting the need to generate evidence-based practice guidelines for UF(NET). |
format | Online Article Text |
id | pubmed-8647664 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Sciendo |
record_format | MEDLINE/PubMed |
spelling | pubmed-86476642021-12-20 Survey of U.S. Critical Care Practitioners on Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Kidney Replacement Therapy Chen, Huiwen Murugan, Raghavan J Crit Care Med (Targu Mures) Research Article INTRODUCTION: The current prescription and practice of net ultrafiltration among critically ill patients receiving kidney replacement therapy in the U.S. are unclear. AIM OF THE STUDY: To assess the attitudes of U.S. critical care practitioners on net ultrafiltration (UF(NET)) prescription and practice among critically ill patients with acute kidney injury treated with kidney replacement therapy. METHODS: A secondary analysis was conducted of a multinational survey of intensivists, nephrologists, advanced practice providers, and ICU and dialysis nurses practising in the U.S. RESULTS: Of 1,569 respondents, 465 (29.6%) practitioners were from the U.S. Mainly were nurses and advanced practice providers (58%) and intensivists (38.2%). The median duration of practice was 8.7 (IQR, 4.2-19.4) years. Practitioners reported using continuous kidney replacement therapy (as the first modality in 60% (IQR 20%-90%) for UF(NET). It was found that there was a significant variation in assessment of prescribed-to-delivered dose of UF(NET), use of continuous kidney replacement therapy for UF(NET), methods used to achieve UF(NET), and assessment of net fluid balance during continuous kidney replacement therapy. There was also variation in interventions performed for managing hemodynamic instability, perceived barriers to UF(NET), belief that early and protocol-based fluid removal is beneficial, and willingness to enroll patients in a clinical trial. CONCLUSIONS: There was considerable practice variation in UF(NET) among critical care practitioners in the U.S., reflecting the need to generate evidence-based practice guidelines for UF(NET). Sciendo 2021-11-06 /pmc/articles/PMC8647664/ /pubmed/34934817 http://dx.doi.org/10.2478/jccm-2021-0034 Text en © 2021 Huiwen Chen, Raghavan Murugan, published by Sciendo https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
spellingShingle | Research Article Chen, Huiwen Murugan, Raghavan Survey of U.S. Critical Care Practitioners on Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Kidney Replacement Therapy |
title | Survey of U.S. Critical Care Practitioners on Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Kidney Replacement Therapy |
title_full | Survey of U.S. Critical Care Practitioners on Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Kidney Replacement Therapy |
title_fullStr | Survey of U.S. Critical Care Practitioners on Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Kidney Replacement Therapy |
title_full_unstemmed | Survey of U.S. Critical Care Practitioners on Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Kidney Replacement Therapy |
title_short | Survey of U.S. Critical Care Practitioners on Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Kidney Replacement Therapy |
title_sort | survey of u.s. critical care practitioners on net ultrafiltration prescription and practice among critically ill patients receiving kidney replacement therapy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647664/ https://www.ncbi.nlm.nih.gov/pubmed/34934817 http://dx.doi.org/10.2478/jccm-2021-0034 |
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