Intermittent hemodialysis using multimodal approach for critically ill patients

Abstract

It has been reported that the multimodal approach (MMA) can stabilize hemodynamics and fluid management during renal replacement therapy for critically ill patients. This method uses prolonged or iterative dialysis and multiple dialysis techniques such as high-sodium, low temperature, acetate-free, and high-calcium dialysates. It is reported that intermittent hemodialysis (IHD) with MMA can achieve hemodynamic stabilization and prognosis equivalent to continuous renal replacement therapy (CRRT), and IHD with MMA may achieve better results than CRRT in cases with stable hemodynamics and cases with lesser severity. The reasons why IHD with MMA improves the prognosis in some subgroups may be due to issues associated with CRRT trauma. In our intensive care unit, we consider using IHD with MMA for patients with CRRT trauma-related issues such as bleeding or malnutrition.