In which clinical scenarios do you use prolonged intermittent renal replacement therapy (PIRRT)?  

I have not been using PIRRT. We talked about it at the height of COVID when we thought we were going to run out of CVVH solutions. However it never needed to be instituted. Other than that scenario, I think we can tweak the settings of the CVVH machine enough to provide aggressive renal replacement ...

I agree with Dr. @Sam. We have a good deal of flexibility in prescribing conventional HD and CRRT to meet the needs of our patients without introducing PIRRT/SLED.