Abstract:

Objective To explore the application effect of a goal-oriented ultrasound protocol in preventing unplanned discontinuation of continuous renal replacement therapy（CRRT） among patients in the intensive care unit （ICU）. Methods The goal-oriented ultrasound protocol was developed through literature review and expert consultation. A total of 120 eligible patients receiving CRRT in the ICU of Affiliated Hospital of Guizhou Medical University from January 2024 to June 2025 were consecutively enrolled. After all subjects were recruited，patients were randomly assigned to the experimental group and control group by random number table，with 60 cases in each group.The control group received conventional CRRT management，while the experimental group received a goal-oriented ultrasound protocol，including risk stratification assessment prior to discontinuation，targeted monitoring，and intervention measures. The incidence of unplanned discontinuation，filter usage duration，precision of fluid balance，and ICU hospitalization duration were compared between the two groups. Results The incidence of unplanned CRRT discontinuation in the experimental group was 11.67%，which was significantly lower than 28.33% in the control group（P<0.05）. The average filter service time and the compliance rate of fluid balance in the experimental group were significantly higher，while the average length of ICU stay was significantly shorter than those in the control group（P<0.05）. Conclusion The goal-oriented ultrasound protocol can effectively reduce the risk of unplanned CRRT discontinuation，prolong filter service life，optimize fluid management，and provide a reference for improving clinical prognosis of ICU critically ill patients.

Key words: Critical Care Ultrasound, Continuous Renal Replacement Therapy, Unplanned CRRT Discontinuation, Fluid Management, Critically Ill Patients