- There is no evidence that the use of either continuous or intermittent therapies have a survival benefit in critical illness
- Continuous modalities have been Several benefits have been proposed from the use of continuous modalities:
- Improved haemodynamic stability and lower rates of therapy-induced hypotension – due to slower and more predictable rates of fluid removal and solute flux
- Increased clearance with continuous modes to aid with the resolution of uraemia and electrolyte imbalance
- Better tolerated in patients with raised intracranial pressure or hepatic encephalopathy due to less rapid shift in solute concentration and preservation of cerebral perfusion
- Better clearance of inflammatory mediators
- Given this international guidance favours the use of continuous therapies in critical illness
- KDIGO guidance recommends continuous therapies in ‘haemodynamically unstable patients’ or those with ‘raised ICP, brain injury or other forms of brain oedema.’
- Surviving sepsis guidance recommends continuous therapies in ‘haemodynamically unstable septic patients
