Recent recommendations from the EXTRIP expert group support intermittent hemodialysis as the modality of choice in methanol poisoning, and continuous modalities as an acceptable alternative in cases of unavailability of intermittent hemodialysis [27].
During the mass methanol poisoning outbreak that occurred in the Czech Republic in 2012 2015, both intermittent and continuous modalities of enhanced elimination were applied [28].
Although not a continuous means of ICP measurement, TCD PI can be performed non-invasively serially, helping to rule in high ICP, and prompting more invasive, continuous modalities.
We compared clinical endpoints, mortality, and the prevalence of long-term visual and central nervous system (CNS) sequelae in the patients treated with intermittent versus continuous modalities of hemodialysis.
Altogether, this study adds to the growing body of evidence to suggest improved likelihood of recovery of kidney function in critically ill survivors of AKI with continuous modalities for renal replacement therapy.
Apparently, more patients in our study seemed to survive without sequelae and less patients died when intermittent hemodialysis was being used as compared to continuous modalities.
However, the comparative clinical effectiveness of intermittent versus continuous modalities (CRRT) is unknown.
Continuous modalities are preferred to prevent intradialytic rebound, and dialysis is more efficient in removing small molecules as lactate [ 58, 59].
Peritoneal dialysis is an often neglected continuous modality in AKI, although it can especially be of help in hemodynamically unstable and fragile patients, in those with enhanced bleeding risk, and in children [ 37], especially neonates and small children with postcardiac surgery AKI and hemolytic uremic syndrome.
In the DOSE registry, patients submitted to higher dose and continuous modality administration revealed an increase in creatinine, although they experienced improvement in their symptoms and significant decongestion signs compared with low-dose administration.
