ABSTRACT
Continuous renal replacement therapy (CRRT) is often regarded as one of the more important advances in intensive care medicine in recent years. The use of CRRT in critically ill patients with acute renal failure (ARF) combined with cardiovascular instability, severe fluid overload, cerebral edema, or hypercatabolism is widely accepted.1 CRRT is also used in some nonrenal indications and these are less well established. These nonrenal indications are based on the presumed elimination of inflammatory mediators (systemic inflammatory response syndrome (SIRS) and sepsis, acute respiratory distress syndrome (ARDS), cardiopulmonary bypass (CPB)), on the removal of fluid (ARDS, CPB, congestive heart failure (CHF)), or on the elimination of nonuremic endogenous toxic solutes (inborn errors of metabolism, lactic acidosis, crush injury, tumor lysis syndrome). This chapter reviews the available evidence for each of these nonrenal indications. The use of CRRT in intoxications will not be discussed.
