Navigating the therapeutic tightrope: Precision use of plasmapheresis and continuous renal replacement therapy in liver failure

Figure 2 Diagrams illustrating various configurations of continuous renal replacement therapy. A: Continuous hemofiltration: Blood flows through the hemofilter membrane, where ultrafiltrate is generated across the membrane, and excess ultrafiltrate is removed above the set volume. Pre-and postfilter replacement fluids are added to maintain balance; B: Continuous hemodialysis: Blood is processed through the hemodialyzer, with dialysate flowing in the opposite direction on the opposite side of the membrane to facilitate solute removal. The effluent consists of spent dialysate plus the volume of ultrafiltrate removed; C: Continuous hemodiafiltration: Blood passes through the hemodiafilter, combining ultrafiltration and dialysis. Dialysate flows in the opposite direction on one side of the membrane, while replacement fluid is infused prefilter and postfilter. In this setup, the replacement solution can also be administered prefilter.