Provision of intermittent renal replacement service outside an ICU is safe and effective

Renal failure following cardiac surgery prolongs the ICU stay [1]. We developed a service in this tertiary cardiothoracic centre to provide intermittent renal replacement therapy (RRT) in designated high-dependency units (HDU) outside the ICU for cardiothoracic patients who have isolated renal failure. This has reduced the ICU length of stay and costs, and allowed other patients to be admitted to the ICU. The service is provided by ICU nurses and supported by the Outreach team, whose remit is to facilitate ICU discharge and to educate ward nurses in critical care skills.