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Water treatment-free prolonged intermittent kidney replacement therapy: A new approach for kidney replacement therapy in the ICU setting. A retrospective study.

J Crit Care

January 2025

AP-HP, Hôpital Louis Mourier, DMU ESPRIT, Service de Médecine Intensive Réanimation, F-92700 Colombes, France; Université Paris Cité, Medical school, F-75018 Paris, France; Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Institut Necker Enfants Malades, F-75015 Paris, France. Electronic address:

The optimal modalities of kidney replacement therapy (KRT) in the ICU remain debated. Intermittent haemodialysis (IHD) and continuous veno-venous haemofiltration (CVVH) are the two main methods. Intermittent haemodialysis requires a water treatment system, which may not be available in all jurisdictions.

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Background: Continuous veno-venous hemodiafiltration (CVVHDF) is used in critically ill patients, but its impact on O₂ and CO₂ removal, as well as the accuracy of resting energy expenditure (REE) measurement using indirect calorimetry (IC) remains unclear. This study aims to evaluate the effects of CVVHDF on O₂ and CO₂ removal and the accuracy of REE measurement using IC in patients undergoing continuous renal replacement therapy.

Design: Prospective, observational, single-center study.

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Systemic-to-pulmonary collaterals (SPCs) are common in congenital heart disease (CHD). Particularly in single ventricle anatomy and Fontan circulation, SPC can both complicate the postoperative course and lead to clinical deterioration in the long term. The treatment of SPC is controversial.

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A fever is an important sign that affects patient outcomes with various etiologies in the post-decannulation period of extracorporeal membrane oxygenation (ECMO); however, the cause is not fully understood. This study aimed to investigate the characteristics and clinical implications of fevers after ECMO decannulation in critically ill patients. We conducted a retrospective, single-center study of adult patients who were successfully weaned off venoarterial (VA) or venovenous (VV) ECMO.

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Background: The discussion of Fontan fenestration is difficult because many institutions have different strategies over time. In our institute, we performed a non-fenestrated Fontan procedure for single-ventricular physiology as our definitive strategy.

Methods: Between August 1999 and December 2007, 72 consecutive patients with single-ventricle physiology underwent extracardiac total cavopulmonary connection without fenestration as our definitive strategy.

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