Center to Advance Palliative Care

For Patients and Families
Partner
Sponsor
 
  Print this page
Views

CAPC Palliative Care Discussion Forum
Palliative Care and the ICU

Next Reply: Re:CRRT
Previous Message: automatic referasl in ICU
Next Message: ICU palliative care barriers in nursing care

Post CRRT
Author: ultrapollo08
Date: Apr 13, 2011 2:09 pm
I am looking for a standard to base the need to initiate CRRT in the ICU. Does anybody use the APACHE II scoring system and predictor of outcomes? If so at what score triggers a case conference or do you require them of all cases prior to starting CRRT?
Replies: order by [Date] [Author] [Subject]
Re:CRRT (by Lustbader on 04/15/2011)
Chronic renal replacement therapy (CRRT) is not based on an APACHE II severity of illness score. CRRT is used for renal replacement therapy for a hemodynamically unstable patient with renal failure for whom conventional hemodialysis might not be tolerated. CRRT is also used to remove excess fluid. CRRT, like all other life sustaining treatments is intended to be used in patients with a reversible disease process. Severity of illness scores like APACHE II are not meant for medical decision making on an individual patient, but rather for evaluating acuity of a cohort of patients or for ICU staffing.
Dana Lustbader MD
Re:CRRT (by Lustbader on 04/15/2011)
Continuous renal replacement therapy (CRRT) is not based on an APACHE II severity of illness score. CRRT is used for renal replacement therapy for a hemodynamically unstable patient with renal failure for whom conventional hemodialysis might not be tolerated. CRRT is also used to remove excess fluid. CRRT, like all other life sustaining treatments is intended to be used in patients with a reversible disease process. Severity of illness scores like APACHE II are not meant for medical decision making on an individual patient, but rather for evaluating acuity of a cohort of patients or for ICU staffing.
Dana Lustbader MD
Re:CRRT (by Lustbader on 04/15/2011)
Continuous renal replacement therapy (CRRT) is not based on an APACHE II severity of illness score. CRRT is used for renal replacement therapy for a hemodynamically unstable patient with renal failure for whom conventional hemodialysis might not be tolerated. CRRT is also used to remove excess fluid. CRRT, like all other life sustaining treatments is intended to be used in patients with a reversible disease process. Severity of illness scores like APACHE II are not meant for medical decision making on an individual patient, but rather for evaluating acuity of a cohort of patients or for ICU staffing.
Dana Lustbader MD
Re:CRRT (by SharolHerr on 04/22/2011)
I would recommend tapping into the expertise of the intensivist or one of the nephrologists at your institution to see what specific criteria they use for initiating the CRRT. Some institutions are using protocols to initiate therapies while others are relying on the expertise of the practitioner. Sharol Herr, RN, BSN, MSEd; Clinical Manager; Mount Carmel Health Palliative Care Leadership Center; Columbus, Ohio.

IMPORTANT: In order to post a new message or reply to an existing post in the discussion you must login. If you are not a registered member you may join here.
The statements posted in the forum section of capc.org are opinions expressed by website visitors and do not necessarily represent the viewpoints or positions of the Center to Advance Palliative Care(CAPC). CAPC is not responsible for the factual or legal accuracy of any of the statements posted.


General questions about using the CAPCconnect™ palliative care discussion forum? EmailPatricia.Caines@mssm.edu

Lost login username/password questions? Email: Margaret.Schutz@mssm.edu