Hemofiltration in Burns: RESCUE (Randomized Controlled Evaluation of Hemofiltration in Adult Burn Patients With Septic Shock and Acute Renal Failure)

"70ml/kg/hr for treatment group for 48 hours with the following requirements:~* double lumen dialysis catheter should be placed in the internal jugular or femoral vein~* Anticoagulation will be determined by prescribing physician~* Use of 1.4 m2 or larger biocompatible synthetic hollow-fiber dialysis membrane that is changed every 24 hours~* Blood flow rate will be set to ensure a filtration fraction of no more than 25%~* Monitoring for electrolytes (specifically K+, Mg, Ca, and phos) during HVHF must be performed at least every 6 hours~* Replacement fluids will be bicarbonate-buffered with appropriate adjustments when citrate-anticoagulation is utilized~* All antibiotics will be dose adjusted for renal replacement therapy"

Both groups will receive 'contemporary' care via consideration of the Burn-specific Sepsis Bundle adapted from the most recent Surviving Sepsis Campaign (SSC) (1) recommendations and specifically modified to our patient population