PHOENIX — Restrictions are being put in place at some Valley hospitals for patients who need continuous renal replacement therapy (CRRT) due to shortages of staff and resources.
CRRT is a slower type of dialysis and the device is used to keep the kidneys functioning — similar to how a ventilator would work to keep a person’s lungs functioning.
An internal memo shared with ABC15 from the chief medical officer with Banner University Medical Center details how an oversight program is being used to prioritize this treatment starting this week.
The memo states that twice a week “the system CRRT workgroup will meet to review any patient who has been on CRRT for more than 5 days or meets exclusion criteria.”
It goes on to say that the group will then “make a determination if the patient can remain on CRRT.”
A spokesperson for Banner Health says there is a national shortage of the solution used for CRRT so this program impacts all Banner hospitals that perform CRRT.
“These types of adjustments are done during COVID and non-COVID times when drugs or supplies are available only on allocation,” a statement reads. “It does not mean that patients receive a lower level of care; we just make adjustments to care plans and utilize other effective treatments.”
Along with supplies — staffing is also a concern as CRRT patients need a high level of continuous care inside of an Intensive Care Unit.
“CRRT is one tool among many for renal patients, and due to limited staffing and supplies, a CRRT oversight program was put in place so that we can continue to offer this therapy for those in whom it will make a significant difference,” a spokesperson for Banner added.
The memo includes initiation criteria and there’s an exclusion list that includes:
- Patient goals are not consistent with CRRT or dialysis generally/patient refuses
- 85 years old (absolute) or older than 75 years old with multiple co-morbidities
- Hospice criteria
- More than 3 organ failures, renal excluded
- SOFA >13 (predicted 80+% mortality)
- Unsupported hemodynamic instability, which prevents safe CRRT initiation
“Our CRRT program does not reduce or eliminate care for renal patients. It simply transitions patients off of CRRT if they are not showing improvement on the treatment after a number of days. CRRT is effective for some and not as effective for others. The program Banner put in place ensures this particular therapy is provided to those whom it will make a significant difference. Renal patients who do not receive CRRT will receive other treatments that are also considered standard of care,” a Banner spokesperson wrote.
The CMO for BUMC also wrote in his letter to staff that the discontinuation of the CRRT devices will be quite rare.