Balancing carbon reduction and treatment adequacy in sustainable continuous renal replacement therapy

Abstract

We thank Huang et al. for their considered analysis of our research article. 1 This retrospective observational study was based at two tertiary intensive care units (ICUs) over an 8-year period, yielding 70,000 h of therapeutic data for analysis. Continuous renal replacement therapy (CRRT) was administered to a broad range of critically ill patients with differing pathologies, necessitating a spectrum of prescriptions and doses. The CRRT guidelines used at both centres are informed by the current evidence base for timing of initiation, 2—6 dialysis dose, 7—9 citrate anticoagulation, 10,11 and blood flow rates. 12,13 Machine-recorded data facilitated quantification of consumables associated with therapies, which was then translated into carbon emissions and costs. We would like to address each discussion point from Huang et al. sequentially: