Mercè Jourdain, Ines Gragueb Chatti, Brahim Housni, Pierre Jaquet, Mélissa Jezequel, Oumar Kane, Béatrice La Combe, Mickael Landais, Mehdi Marzouk, Etienne de Montmollin, Guillaume Mortamet, Mai-Anh Nay, Charlotte Salmon-Gandonnière, Sophie Perinel-Ragey, Jérôme Rambaud, Joanna Schmitt, Marie Simon, Julie Starck, Arnaud W Thille, Pierre-François Dequin
{"title":"重症监护病房的肾脏替代治疗：来自SRLF-GFRUP共识会议的指南","authors":"Mercè Jourdain, Ines Gragueb Chatti, Brahim Housni, Pierre Jaquet, Mélissa Jezequel, Oumar Kane, Béatrice La Combe, Mickael Landais, Mehdi Marzouk, Etienne de Montmollin, Guillaume Mortamet, Mai-Anh Nay, Charlotte Salmon-Gandonnière, Sophie Perinel-Ragey, Jérôme Rambaud, Joanna Schmitt, Marie Simon, Julie Starck, Arnaud W Thille, Pierre-François Dequin","doi":"10.1186/s13613-025-01517-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although largely used, the place of extracorporeal renal replacement therapy (RRT) in acute kidney injury (AKI) in intensive care unit (ICU) patients has yet to be clarified. The French Intensive Care Society (Société de Réanimation de Langue Française, SRLF) and the French Pediatric Group of Intensive Care and Emergency (Groupe Francophone de Réanimation et d'Urgence Pédiatrique, GFRUP) organized a consensus conference in November 2024.</p><p><strong>Methods: </strong>A committee, without any conflict of interest (CoI) on the subject, defined seven generic questions and drew up a list of sub questions according to the population, intervention, comparison and outcomes (PICO) model. An independent work group reviewed literature using predefined keywords. The quality of the data was assessed using the GRADE methodology. Eighteen experts in the field from both societies proposed their own answers in a public session and answered questions from the jury (a panel of 14 critical-care medicine physicians and a nurse) and the public. The jury then met for 48 h to write out and vote on its recommendations.</p><p><strong>Results: </strong>The panel provided 45 statements addressing seven questions. In patients, adults or children, admitted to the ICU with AKI (1) What are the indications for RRT, when should it be initiated, and within what timeframe? (2) What are the advantages/disadvantages of the different RRT modalities in ICU, and based on what criteria should they be chosen? (3) Which dose of dialysis should be prescribed for ICU patients? (4) How to prescribe, adjust and monitor each RRT technique? (5) Which vascular access technique should be preferred (insertion site, catheter type and length)? (6) How to prevent circuit thrombosis? (7) What are the criteria to consider weaning from RRT and how can it be achieved?</p><p><strong>Conclusions: </strong>These recommendations should optimize the prescription and use of RRT during AKI in ICUs for both adult and pediatric patients.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"100"},"PeriodicalIF":5.5000,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267776/pdf/","citationCount":"0","resultStr":"{\"title\":\"Renal replacement therapy in an intensive care unit: guidelines from the SRLF-GFRUP consensus conference.\",\"authors\":\"Mercè Jourdain, Ines Gragueb Chatti, Brahim Housni, Pierre Jaquet, Mélissa Jezequel, Oumar Kane, Béatrice La Combe, Mickael Landais, Mehdi Marzouk, Etienne de Montmollin, Guillaume Mortamet, Mai-Anh Nay, Charlotte Salmon-Gandonnière, Sophie Perinel-Ragey, Jérôme Rambaud, Joanna Schmitt, Marie Simon, Julie Starck, Arnaud W Thille, Pierre-François Dequin\",\"doi\":\"10.1186/s13613-025-01517-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although largely used, the place of extracorporeal renal replacement therapy (RRT) in acute kidney injury (AKI) in intensive care unit (ICU) patients has yet to be clarified. The French Intensive Care Society (Société de Réanimation de Langue Française, SRLF) and the French Pediatric Group of Intensive Care and Emergency (Groupe Francophone de Réanimation et d'Urgence Pédiatrique, GFRUP) organized a consensus conference in November 2024.</p><p><strong>Methods: </strong>A committee, without any conflict of interest (CoI) on the subject, defined seven generic questions and drew up a list of sub questions according to the population, intervention, comparison and outcomes (PICO) model. An independent work group reviewed literature using predefined keywords. The quality of the data was assessed using the GRADE methodology. Eighteen experts in the field from both societies proposed their own answers in a public session and answered questions from the jury (a panel of 14 critical-care medicine physicians and a nurse) and the public. The jury then met for 48 h to write out and vote on its recommendations.</p><p><strong>Results: </strong>The panel provided 45 statements addressing seven questions. In patients, adults or children, admitted to the ICU with AKI (1) What are the indications for RRT, when should it be initiated, and within what timeframe? (2) What are the advantages/disadvantages of the different RRT modalities in ICU, and based on what criteria should they be chosen? (3) Which dose of dialysis should be prescribed for ICU patients? (4) How to prescribe, adjust and monitor each RRT technique? (5) Which vascular access technique should be preferred (insertion site, catheter type and length)? (6) How to prevent circuit thrombosis? (7) What are the criteria to consider weaning from RRT and how can it be achieved?</p><p><strong>Conclusions: </strong>These recommendations should optimize the prescription and use of RRT during AKI in ICUs for both adult and pediatric patients.</p>\",\"PeriodicalId\":7966,\"journal\":{\"name\":\"Annals of Intensive Care\",\"volume\":\"15 1\",\"pages\":\"100\"},\"PeriodicalIF\":5.5000,\"publicationDate\":\"2025-07-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267776/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Intensive Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13613-025-01517-0\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Intensive Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13613-025-01517-0","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Renal replacement therapy in an intensive care unit: guidelines from the SRLF-GFRUP consensus conference.
Background: Although largely used, the place of extracorporeal renal replacement therapy (RRT) in acute kidney injury (AKI) in intensive care unit (ICU) patients has yet to be clarified. The French Intensive Care Society (Société de Réanimation de Langue Française, SRLF) and the French Pediatric Group of Intensive Care and Emergency (Groupe Francophone de Réanimation et d'Urgence Pédiatrique, GFRUP) organized a consensus conference in November 2024.
Methods: A committee, without any conflict of interest (CoI) on the subject, defined seven generic questions and drew up a list of sub questions according to the population, intervention, comparison and outcomes (PICO) model. An independent work group reviewed literature using predefined keywords. The quality of the data was assessed using the GRADE methodology. Eighteen experts in the field from both societies proposed their own answers in a public session and answered questions from the jury (a panel of 14 critical-care medicine physicians and a nurse) and the public. The jury then met for 48 h to write out and vote on its recommendations.
Results: The panel provided 45 statements addressing seven questions. In patients, adults or children, admitted to the ICU with AKI (1) What are the indications for RRT, when should it be initiated, and within what timeframe? (2) What are the advantages/disadvantages of the different RRT modalities in ICU, and based on what criteria should they be chosen? (3) Which dose of dialysis should be prescribed for ICU patients? (4) How to prescribe, adjust and monitor each RRT technique? (5) Which vascular access technique should be preferred (insertion site, catheter type and length)? (6) How to prevent circuit thrombosis? (7) What are the criteria to consider weaning from RRT and how can it be achieved?
Conclusions: These recommendations should optimize the prescription and use of RRT during AKI in ICUs for both adult and pediatric patients.
期刊介绍：
Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.
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