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Open AccessArticle

A Continuous Renal Replacement Therapy Protocol for Patients with Acute Kidney Injury in Intensive Care Unit with COVID-19

1
Department of Medicine, Nephrology, Dialysis and Transplantation Unit, University of Padova, 35128 Padova, Italy
2
Healthcare Directorate Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padova, Italy
3
Emergency-Urgency Department, Anesthesia and Intensive Care, Azienda Ospedaliera di Padova University of Padova, 35128 Padova, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(5), 1529; https://doi.org/10.3390/jcm9051529
Received: 7 April 2020 / Revised: 30 April 2020 / Accepted: 18 May 2020 / Published: 19 May 2020
(This article belongs to the Section Nephrology & Urology)
COVID-19 often leads to acute respiratory distress syndrome complicated by acute kidney injury (AKI). The indications for renal replacement therapy for these patients are those commonly accepted to treat AKI. We describe a continuous veno-venous haemodialysis (CVVHD) protocol for AKI, which aims to provide the best treatment according to the particular patient’s and medical personnels’ needs in biohazard settings with limited human and technological resources. We designed a CVVHD protocol with a high cut-off (HCO) filter in regional citrate anticoagulation (RCA). The HCO filter in diffusion determines the enhanced cytokines clearance with less filter clotting due to a lower filtration fraction. In our hospital, at the beginning of the pandemic outbreak, we treated seven COVID-19 patients with AKI stage 2 and 3 and recorded the circuit lifespan and the number of interventions on monitors. CVVHD in RCA appears to be safe, effective and easy to be performed in a biohazard scenario using lower blood flows and less bag changes with fluid savings, a biohazard reduction and sparing of resources. Although the data come from a very small cohort, our protocol seems related to a low mortality.
Keywords: Covid-19; AKI; ARDS; CRRT; CVVHD; HCO; cytokines; intensive care Covid-19; AKI; ARDS; CRRT; CVVHD; HCO; cytokines; intensive care
MDPI and ACS Style

Nalesso, F.; Garzotto, F.; Cattarin, L.; Gobbi, L.; Qassim, L.; Sgarabotto, L.; Tiberio, I.; Calò, L.A. A Continuous Renal Replacement Therapy Protocol for Patients with Acute Kidney Injury in Intensive Care Unit with COVID-19. J. Clin. Med. 2020, 9, 1529.

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