RCA for CRRT in Hyperlactatemia Patient With Increased Bleeding Risk

Inclusion Criteria: * Age≥16 years * Hyperlactatemia (Lactic acid or serum lactate level \> 2 mmol/L) * Required CRRT * Increased bleeding risk: PLT \< 40 x 109, aPTT \> 60 s, INR \> 1.5, bleeding or active bleeding within 7 days, recent trauma or surgery (especially head trauma and neurosurgery), recent stroke, intracranial venous malformation or aneurysm, retinal hemorrhage, uncontrolled hypertension, and epidural catheter implantation. Exclusion Criteria: * Drugs (biguanide, linezolid, cyanide, etc.) and congenital metabolic disorders (glucose-6 phosphatase and 1,6 phosphofructosase deficiency) and mitochondrial damage caused hyperlactatemia. * Receiving systemic anticoagulant treatment (heparin/lmol/warfarin/aspirin, etc.) within 24 hours. * Critical patients with lactic acid ≥15mmol\\L (with a mortality of 100%) were excluded * Patients with APTT \> 100S were excluded (retrospective data suggested that this type of patients received CRRT treatment should last for more than 24 hours) * Patients who are pregnant or during lactation * Severe liver failure: child-pugh score \>10 (chronic severe liver failure), MELD score \> 30 (acute severe liver failure), total bilirubin \>51 mol/L * Patients with internal fistula were treated with CRRT * Unable to cooperate with treatment due to mental problems (such as depression and mental illness) * CRRT with arteriovenous fistula, or the prescribed treatment time \< 12 hours