Table 3 Modifications to intermittent dialytic techniques (IHD and PIRRT) to prevent further ABI
Modification item | Recommendation |
|---|---|
Dialyzer | Use membranes with small surface area |
blood flow | If using IHD or PIRRT, consider using lower blood flows of < 300 mL/min |
Dialysate flow | Consider using lower dialysate flow rates for IHD/PIRRT (< 600 mL/min) and lower effluent rates for CRRT (20 mL/kg/h) |
Ultrafiltration Rate | Avoid high net ultrafiltration rates (< 10 mL/kg/h for IHD and < 2 mL/kg/h for CRRT) |
Vasopressor | Consider using vasopressors to keep MAP and CPP goals |
Dialysate temperature | Cool dialysate to 35 °C |
Electrolytes | Use higher dialysate sodium concentration Use lower dialysate bicarbonate concentration Use higher dialysate calcium concentration |
Frequency | Daily dialysis to minimize peaks and troughs in serum BUN levels |