Abstract：
BACKGROUND: Historically IV and enteral fluids given during acute kidney injury (AKI) were restricted before the introduction of continuous renal replacement therapies (CRRTs) when more liberal fluids improved nutrition for the critically ill. However, fluid accumulation can occur when higher volumes each day are not considered in the fluid balance prescribing and the NET ultrafiltration (NUF) volume target.
CONCLUSIONS: The delivered hours of CRRT each day are vital for achievement of fluid balance and time off therapy makes the task more challenging. Clinicians inexperienced with CRRT make this aspect of AKI management a focus of rounding with senior oversight, clear communication, and \"precision\" a clinical target. Sepsis-associated AKI can be a complex patient where resuscitation and admission days are with a positive fluid load and replacement mind set. Subsequent days in ICU requires fluid regulation, removal, with a comprehensive multilayered assessment before prescribing the daily fluid balance target and the required hourly NET plasma water removal rate (NUF rate). Future machines may include advanced software, new alarms - display metrics, messages and association with machine learning and \"AKI models\" for setting, monitoring, and guaranteeing fluid removal. This could also link to current hardware such as on-line blood volume assessment with continuous haematocrit measurement.
CONCLUSIONS: Fluid balance in the acutely ill is a challenge where forecasting and prediction are necessary. NUF rate and volume each hour should be tracked and adjusted to achieve the daily target. This requires human and machine connections.
CONCLUSIONS: The delivered hours of CRRT each day are vital for achievement of fluid balance and time off therapy makes the task more challenging. Clinicians inexperienced with CRRT make this aspect of AKI management a focus of rounding with senior oversight, clear communication, and \"precision\" a clinical target. Sepsis-associated AKI can be a complex patient where resuscitation and admission days are with a positive fluid load and replacement mind set. Subsequent days in ICU requires fluid regulation, removal, with a comprehensive multilayered assessment before prescribing the daily fluid balance target and the required hourly NET plasma water removal rate (NUF rate). Future machines may include advanced software, new alarms - display metrics, messages and association with machine learning and \"AKI models\" for setting, monitoring, and guaranteeing fluid removal. This could also link to current hardware such as on-line blood volume assessment with continuous haematocrit measurement.
CONCLUSIONS: Fluid balance in the acutely ill is a challenge where forecasting and prediction are necessary. NUF rate and volume each hour should be tracked and adjusted to achieve the daily target. This requires human and machine connections.
摘要：
背景：历史上，急性肾损伤（AKI）期间的静脉和肠内液体在引入连续性肾脏替代疗法（CRRT）之前受到限制，因为更多的液体可以改善危重症患者的营养。然而，当在净超滤（NUF）体积目标的流体平衡处方和每日审查中未考虑每天较高的体积时，可能会发生流体积聚。
结论：每天进行CRRT的时间对于实现体液平衡至关重要，而休假治疗使任务更具挑战性。缺乏CRRT经验的临床医生使AKI管理的这一方面成为高级监督四舍五入的重点，清晰的沟通,和“精确”一个临床目标。与脓毒症相关的AKI可能是一个复杂的患者，其中复苏和入院日具有积极的液体负荷和更换心态。随后在ICU的几天需要调节液体，移除,在规定每日流体平衡目标和实现此目标所需的每小时净血浆水去除率（NUF率）之前，进行全面的多层评估。预测和预测是必要的。
结论：未来的机器可能包括高级软件，新警报-显示指标，消息和与机器学习和“AKI模型”的关联，用于设置，监测,并保证流体去除。这也可以链接到当前的硬件,例如具有连续血细胞比容测量的在线血容量评估。
结论：每天进行CRRT的时间对于实现体液平衡至关重要，而休假治疗使任务更具挑战性。缺乏CRRT经验的临床医生使AKI管理的这一方面成为高级监督四舍五入的重点，清晰的沟通,和“精确”一个临床目标。与脓毒症相关的AKI可能是一个复杂的患者，其中复苏和入院日具有积极的液体负荷和更换心态。随后在ICU的几天需要调节液体，移除,在规定每日流体平衡目标和实现此目标所需的每小时净血浆水去除率（NUF率）之前，进行全面的多层评估。预测和预测是必要的。
结论：未来的机器可能包括高级软件，新警报-显示指标，消息和与机器学习和“AKI模型”的关联，用于设置，监测,并保证流体去除。这也可以链接到当前的硬件,例如具有连续血细胞比容测量的在线血容量评估。
