December 3, 2019

Significant variation in practice of net ultrafiltration

Results of study investigating the attitudes of care providers towards fluid removal practices


A paper was recently published in Critical Care Medicine which relates to the multinational survey endorsed by ESICM and the AKI Section in 2018.

The survey concerned Fluid Removal Practices During Renal Replacement Therapy in Critically Ill Patients (FluidRRT) and its purpose was to study the attitudes of care providers towards fluid removal practices during renal replacement therapy for critically ill patients with oliguric acute kidney injury and fluid overload in an adult intensive care unit.

The Principal Investigator of the research was Dr. Raghavan Murugan, University of Pittsburgh, Pittsburgh, USA and the Steering Committee included Professor Eric Hoste, University of Ghent, Ghent-Belgium, Chair of AKI section and Dr Marlies Ostermann Guy’s & St Thomas’ Hospital, London-UK.

Respondents to the survey included critical care practitioners from 80 different countries; Intensivists, nephrologists, advanced practice providers, ICU and dialysis nurses.

The article states that the study provides new knowledge about the presence and extent of international practice variation in net ultrafiltration.  Through the survey, it was possible to identify barriers and specific targets for quality improvement initiatives. Our data reflect the need for evidence-based practice guidelines for net ultrafiltration.

In this multinational survey, we also found significant regional variation in the prescription and practice of net ultrafiltration, which may be partly due to the absence of evidence-based recommendations and guidelines.   Thus, there remains a compelling need for further research to generate evidence to define best practices that improve patient outcomes and subsequently, interventions that reduce variation in practice.


Access the paper : “Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Renal Replacement Therapy: A Multinational Survey of Critical Care Practitioners“.

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