Episode 33: Extracorporeal Purification Therapy - Is It Indicated?
Free tool: https://academy.vetemcrit.com/ecpt
The VetEmCrit Academy built for ER and ICU vets who want to grow, level up, and learn together: https://academy.vetemcrit.com/join
In this episode we walk you through a new decision support tool we built for the Academy - Extracorporeal Therapy: Is It Indicated? It covers renal replacement therapy, hemoperfusion and therapeutic plasma exchange in dogs and cats, and it is written for those who do not run these circuits ourselves, because the hard part is knowing whether a particular patient might benefit, how urgent the call is, and whom to call. The tool asks three questions behind one front door: does this AKI or acute-on-chronic patient meet a published trigger for a renal replacement therapy consultation, is this an immune-mediated disease where plasma exchange might help, and can this toxin be removed with a circuit. We start with the kidney arm and the pre-check it forces you through first - a hypotensive dog and an obstructed cat can both carry a high creatinine, and neither belongs on a dialysis referral on that number alone - then the creatinine trend and hydration status that make the IRIS trigger what it is, the urine output step with its maintenance-rate warning, and a worked case in a 20-kilo dog that lands on "call a dialysis center now". From there we move to the immune-mediated arm, and we finish with the poisoning arm: the five numbers that decide whether extracorporeal removal can work, the four published questions in sequence, the carprofen half-life arithmetic, and the modality algorithm and pharmacokinetic table you can work through for your own case. It is built on three recent best practice consensus guidelines.
The tool for members: https://academy.vetemcrit.com/ecpt.
Video tutorials: https://academy.vetemcrit.com/tools-demo
Academy members can also watch the video version in the Renal module of VetEmCrit Academy Rounds, followed by a short quiz with three new cases to test how well you navigate the tool.
If you enjoy this episode and want the full experience, weekly deep-dives, interactive simulators, and clinical algorithms you can use on shift, come join us inside the VetEmCrit Academy.
