International guidelines recommend net extracorporeal fluid removal (i.e., net ultrafiltration [UF_NET]) for critically ill patients with oliguric acute kidney injury (AKI) and fluid overload [1]. However, the optimal approach to UF_NET remains unclear, with significant global variation in clinical practice [2, 3]. Key uncertainties include when to initiate fluid removal, the appropriate volume and rate, and the ideal patient population. Recent surveys highlight the need for research to address these questions, including the role of vasopressors, diagnostic tools to guide fluid removal, and the rate of fluid removal [3]. Moreover, many surveyed clinicians identified conducting clinical trials of UF_NET as a high priority since no validated protocol exists for UF_NET [2, 3].

中文翻译：

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连续性肾脏替代治疗期间的方案化体液平衡中和


国际指南推荐，对于少尿性急性肾损伤 （AKI） 和液体超负荷的危重患者，应进行净体外液体清除（即净超滤 [net ultrafiltration [UF_NET]）[1]。然而，UF_NET 的最佳方法仍不清楚，临床实践的全球差异很大 [2， 3]。关键的不确定性包括何时开始排液、适当的容量和速度以及理想的患者群体。最近的调查强调了需要通过研究来解决这些问题，包括血管加压药的作用、指导液体清除的诊断工具以及液体清除速度[3]。此外，许多受访临床医生认为进行 UF_NET 的临床试验是高度优先事项，因为没有经过验证的 UF_NET 方案 [2， 3]。