CRRT
basics of machine
1. baxter, Edwards, nx stage.
blood flow rates
150-300 ml/min
blood pump
roller pump, creates negative pressure from pt side to draw blood from pt, creates positive pressure from machine side to drive blood from filter back to pt.
filter
build with hollow fiber membrane tubes (tiny hairs). blood flows from bottom to top.
why use CRRT?
critical ill, unstable pt with AKI,ESRD, too unable to receive normal HD.
pt CRRT is define for
critically ill pts unable to tolerate rapid fluid removal. runs 24 hrs a day.
pressure monitoring
access, pre filter, return, effluent
pre filter
positive
return
positive
what is CRRT?
continue renal replacement therapy
access line colors
red for access and blue for return.
return lumen (blue)
distal port
access line (red)
draw from proximal port. minimize filtered blood from going back to the access site.
main indications for CRRT
elevated toxins, fluid volume overload, severe electrolyte/acid base imbalances. Sepsis (cytosine clearnece) rhabdomyolysis, CHF, S/P heart surgery.
main job of the kidney & nephron
maintain fluid, electrolyte, waste, acid base balance
access
negative
effluent
negative
goal of CRRT
remove toxins, excess flid and balance, electrolytes. MIMIC Kidneys.
access sites of CRRT
remover blood from pt run it through the machine, return blood back to pt. Newley place catheters 12-14 g double lumen. placed in IJ, subclavian or femoral.
what medications will these pts require?
require Pressors to maintain BP.
SLED
slow low efficient dialysis, last 6-8 hrs.