Статья

Net ultrafiltration prescription survey in Europe

N. Lumlertgul, R. Murugan, N. Seylanova, P. McCready, M. Ostermann,
2021

Background: Fluid overload is common in patients in the intensive care unit (ICU) and ultrafiltration (UF) is frequently required. There is lack of guidance on optimal UF practice. We aimed to explore patterns of UF practice, barriers to achieving UF targets, and concerns related to UF practice among practitioners working in Europe. Methods: This was a sub-study of an international open survey with focus on adult intensivists and nephrologists, advanced practice providers, and ICU and dialysis nurses working in Europe. Results: Four hundred eighty-five practitioners (75% intensivists) from 31 countries completed the survey. The most common criteria for UF initiation was persistent oliguria/anuria (45.6%), followed by pulmonary edema (16.7%). Continuous renal replacement therapy was the preferred initial modality (90.0%). The median initial and maximal rate of net ultrafiltration (UFNET) prescription in hemodynamically stable patients were 149 mL/hr. (IQR 100–200) and 300 mL/hr. (IQR 201–352), respectively, compared to a median UFNET rate of 98 mL/hr. (IQR 51–108) in hemodynamically unstable patients and varied significantly between countries. Two-thirds of nurses and 15.5% of physicians reported assessing fluid balance hourly. When hemodynamic instability occurred, 70.1% of practitioners reported decreasing the rate of fluid removal, followed by starting or increasing the dose of a vasopressor (51.3%). Most respondents (90.7%) believed in early fluid removal and expressed willingness to participate in a study comparing protocol-based fluid removal versus usual care. Conclusions: There was a significant variation in UF practice and perception among practitioners in Europe. Future research should focus on identifying the best strategies of prescribing and managing ultrafiltration in critically ill patients. © 2020, The Author(s).

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  • 1. Version of Record от 2021-04-27

Метаданные

Об авторах
  • N. Lumlertgul
    Department of Critical Care, King’s College London, Guy’s & St Thomas’ Hospital, NHS Foundation Trust, London, SE1 7EH, United Kingdom
  • R. Murugan
    Division of Nephrology, Department of Internal medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • N. Seylanova
    Excellence Center in Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • P. McCready
    Research Unit in Critical Care Nephrology, Chulalongkorn University, Bangkok, Thailand
  • M. Ostermann
    The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Название журнала
  • BMC Nephrology
Том
  • 21
Выпуск
  • 1
Страницы
  • -
Ключевые слова
  • furosemide; hypertensive agent; anuria; Article; clinical practice; continuous renal replacement therapy; dialysis; diuresis; Europe; fluid balance; health care delivery; health personnel attitude; hemodialysis; hemodynamics; human; hypervolemia; hypotension; intensive care unit; intensivist; lung edema; nephrologist; nurse; oliguria; physician; population research; prescription; tachycardia; ultrafiltration
Издатель
  • BioMed Central Ltd
Тип документа
  • journal article
Тип лицензии Creative Commons
  • CC
Правовой статус документа
  • Свободная лицензия
Источник
  • scopus