In 1995, the First International Conference on Continuous Renal Replacement Therapy named this technique as continuous renal replacement therapy (CRRT). In 1995, the first International Conference on Continuous Renal Replacement Therapy named this technique as continuous renal replacement therapy (CRRT), which is defined as a continuous blood purification therapy to replace impaired renal function for 24 h or nearly 24 h per day. In recent years, CRRT technology has become increasingly mature, and its clinical application has extended far beyond the field of renal replacement therapy to emergency treatment of various common clinical critical cases, beyond the limitations of renal replacement therapy, and this technology is commonly used in intensive care units (ICUs) abroad. The clinical efficacy evaluation is becoming more and more affirmative, and the term CRRT seems to be unable to fully summarize the actual content of this technology, therefore, the authors believe that the term “CBP” is more in line with the actual clinical content and is more conducive to the development of this technology. I. Progress of CBP technology: In 1977, Kramer et al. first applied continuous arteriovenous hemodiafiltration (CAVH) in clinical practice, which largely overcame the defects of “non-physiological” treatment of traditional intermittent hemodialysis (IHD) and marked the birth of a new continuous hemodialysis technology. This marked the birth of a new continuous hemodialysis technique. In April 1982, the FDA approved CAVH for use in ICU, which led to the development of continuous arteriovenous hemodialysis (CAVHD), arteriovenous slow continuous ultrafiltration (CAVSCUF), continuous arteriovenous hemodialysis filtration (CAVHDF) and other techniques. With the popularization of central venous double-lumen catheters in clinical practice, veno-venous hemodiafiltration (CVVH) was developed, and the introduction of CVVH signified that the CAVH system became more complex, requiring blood pumps to drive the blood circulation and volume balance control system. Subsequently, veno-venous slow continuous ultrafiltration (VVSCUF), continuous veno-venous hemodialysis (CVVHD), and continuous veno-venous hemodialysis filtration (CVVHDF) were developed. “In 1992, Grootendorst et al. proposed high volume hemodiafiltration (HVHF), in 1998 Ronco proposed continuous high throughput dialysis (CHFD), and in 1998 Tetta et al. proposed continuous plasma filtration adsorption (CPFA), In 2000, the authors proposed to rename CRRT as CBP, and the development and promotion of CBP technology in China has not yet received sufficient attention and development, which still requires the collaboration and joint efforts of ICU doctors and nephrologists, and is of great significance to improve the treatment of critically ill patients in China. 1. Hemodynamic stability: It is well known that acute renal failure (ARF) can directly lead to death due to excessive volume load, the primary goal of IHD treatment is to remove water, usually 3 times a week, each time to remove the input volume of 2 days plus the endogenous water in the patient’s body, these large amounts of fluid have to be removed in a short time, which may cause hemodynamic imbalance and frequent hypotension. It has been shown that the incidence of hypotension increases significantly when the ultrafiltration rate is greater than 0135 ml?min- 1?kg- 1 body weight, and the incidence of hypotension is as high as 60% when the ultrafiltration rate is greater than 016 ml?min- 1?kg- 1 body weight. Currently, many reports suggest that CBP is safe and well tolerated in the treatment of critically ill ARF patients in the ICU, especially in those who are prone to hypotension and cardiac instability during IHD. CBP has been reported to be safe and well tolerated in patients with severe ARF in the ICU, especially in those who are prone to hypotension and cardiac instability on IHD. Compared with IHD, CBP is a continuous, slow, isotonic removal of water and solutes, which can continuously regulate fluid balance and remove more fluid volume, more in line with the physiological condition. 2. Correction of acid-base disorders: Acid-base disorders in critically ill patients are determined by the renal, pulmonary and hepatic functions and catabolic status of the patients. The treatment modality, replacement fluid and dialysate composition are also important factors when applying CBP therapy. Regardless of the treatment modality, it is important to avoid large fluctuations in the severe acid-base state. In severe metabolic acidosis, it is not advisable to correct the pH above 7125 for 24 hours, otherwise there will be serious adverse consequences. The most basic theory of CBP is to maintain a more physiological profile, it is a slow, continuous solute removal, and over the course of treatment, CBP removes significantly more cumulative urotoxins than would be achieved with 4 weekly IHDs. CBP treatment resulted in stable levels of azotemia and lower concentrations of uremic toxins, while IHD had peaks and valleys of azotemia and higher average concentrations of uremic toxins. Many studies have found that CBP has a higher uremic toxin clearance rate than IHD, and that the weekly KT/V value for IHD (7 times/week) is equivalent to a CBP replacement volume of 1 L/h. If the CBP replacement volume is increased to 2 L/h, then IHD would have to be performed 7 times/week at 6-8 h/time to achieve the same uremic toxin clearance rate. It has also been reported that CVVHD has a better solute clearance and metabolic balance than CVVH because CVVH removes solutes in a convective manner and therefore has a lower clearance rate for small molecules than CVVHD, but CVVH has a higher clearance rate for solutes with molecular weights greater than 25,000. The authors concluded that high volume hemofiltration can greatly increase the clearance of medium and large molecule solutes. Nutritional support: Patients with ARF require at least 125-146 kJ?kg-1?d-1 of calories per day from sugar and fat and 115-117 g?kg-1?d-1 of amino acids, CBP not only provides the “space” for nutritional support, but also controls the levels of metabolites, metabolic acidosis and phosphorus. The CBP not only provides “space” for nutritional support, but also controls metabolite levels, metabolic acidosis, and blood phosphorus, which provide adequate coverage for nutritional support therapy and intravenous medication. In CAVHD, the amino acid loss was 12 g/24 h at a dialysate flow rate of 1 L/h and 310-819 g/24 h in CAVH and CVVH; if the patient consumed sufficient amino acids, the loss of amino acids in CBP therapy would not have a negative prognosis and a positive nitrogen balance could be achieved with conventional nutrition. Because of the unsatisfactory control of azotemia and volume balance in IHD, nutritional support is clinically limited, and protein intake is often restricted to about 015 g?kg-1?d-1 in critically ill patients treated with IHD, so that patients have a significant negative nitrogen balance (up to 210 g/d or more). In addition, the amount of intravenous fluid intake is limited during IHD treatment, resulting in insufficient caloric intake. Since CBP removes phosphate, it must be supplemented after a few days of treatment. 5. Removal of inflammatory mediators: CBP has long been used in the treatment of patients with sepsis and multiple organ dysfunction syndrome (MODS). Recent studies have shown that CBP can remove inflammatory mediators (IL21, IL26, IL28, TNF2α, PAF, etc.), which brings a new concept to the treatment of MODS, whose main mechanism is solute removal by convection and adsorption. The clearance of inflammatory mediators is influenced by the mediator itself and the CBP modality. Inflammatory mediator factors include: molecular weight, molecular conformation, charge, hydrophilicity, hydrophobicity, protein binding rate, acute temporal response and receptor characteristics; CBP modality includes: filter screening factor, transmembrane pressure, membrane adsorption capacity and therapeutic dose. The effective clearance of inflammatory mediators requires three conditions: (i) meaningful in vitro clearance compared to overall levels; (ii) meaningful in vitro clearance compared to in vivo clearance; and (iii) meaningful in vitro clearance for disease control. Therefore, most scholars especially advocate high volume hemofiltration, which increases the therapeutic dose and can greatly improve the clearance of inflammatory mediators.