Continuous Renal Replacement Therapy (CRRT)
_______________ are used to prevent clotting; they can be used infused as a bolus at the initiation of CRRT or through an infusion port before the hemofilter.
anticoagulants
_______________ is a method used for treating AKI; it can also be used in conjunction with HD.
Continuous Renal Replacement Therapy (CRRT)
Removes both fluids and solutes. Requires both dialysate and replacement fluid.
Continuous Venovenous Hemodialysis (CVVHD) and Continuous Venovenous Hemodiafiltration (CVVHDF)
Removes both fluid and solutes. Replacement fluid needed
Continuous Venovenous Hemofiltration (CVVH)
Treatment is continuous can last up to 24hrs to weeks Solute removal can occur by convection in addition to osmosis and diffusion without dialysate It causes less hemodynamic instability (hypotension) Does not need specialized personnel and can be monitored by ICU Nurse Requires less Equipment then HD; only a blood pump
Features of CRRT in comparison to HD
Obtain weight Obtain Serum Lab Values VS q hour I & O's Maintain Patency of CRRT System Assess site for infection
Nursing Considerations for CRRT
Simplified version of CVVH. Removes fluid only. No fluid replacement needed.
Slow Continuous Ultrafiltration (SCUF)
CRRT can be continued for as long as 30-40 days, but _____________ should be changed every 24-48 hours to prevent filtration loss efficiency and potential for clotting.
hemofilter
Vascular Access Sites for CRRT are through the ____________ or ____________ vein with a ____________ ___________ _________.
juglar, femoral, double-lumen catheter
CRRT is contraindicated in patients that have _______________________ manefistations of uremia. (hyperkalemia, perircarditis)
life-threatening
CRRT can also replace ____________ with replacement fluid for solutes such as sodium, chloride, bicarbonate, and glucose.
solutes
Ultrafiltrate for CRRT should be ___________ in color with not blood tinge; otherwise suspect membrane rupture or bleed.
yellow