EP24 — Kidney Crisis: Mastering AKI & CRRT in the Field (SOP 027)

Welcome to episode 24 of the rescEU ICU Briefing! Today, senior intensivist Dr James Whitfield and senior ICU nurse Sister Eleanor Hayes delve into a critical topic: Acute Kidney Injury (AKI) and Continuous Renal Replacement Therapy (CRRT), as outlined in SOP: Annex 4.6-027 (IT ICU SCT). In this episode, we break down the standardised guidelines for the initiation, modality, and management of CRRT in adult patients with AKI within a field Intensive Care Unit, focusing on regional citrate-calcium anticoagulation. What we cover: Understanding the purpose and scope of SOP 027 for AKI and CRRT. Key indications and contraindications for initiating CRRT in a field ICU. Selecting the appropriate CRRT modality (CVVH, CVVHD, CVVHDF) and initial prescription parameters. Detailed guidance on the Regional Citrate Anticoagulation (RCA) protocol, including monitoring systemic and circuit ionised calcium. Essential monitoring and safety checks to ensure effective and safe CRRT delivery. Criteria for CRRT discontinuation and transition of care. By the end of this briefing, you should be able to: Recognise the indications and contraindications for CRRT initiation according to SOP 027. Describe the principles of regional citrate anticoagulation and its monitoring. Identify appropriate CRRT modalities and key prescription parameters. Implement the standardised monitoring and safety checks for patients on CRRT. Remember, this podcast supplements, but does not replace, the official rescEU ICU SOP 027 v1.0. Always refer to the most current version of the SOP for definitive guidance and procedures. Please note: This podcast is intended for educational purposes and reflects the content of the specified SOP. Clinical decisions must always be made by qualified medical professionals based on the individual patient’s condition and current guidelines. This content may contain general information and is not a substitute for professional medical advice, diagnosis, or treatment. Co-funded by the European Union.