Continuous Renal Replacement Therapy (CRRT)
ideal treatment for a patient who needs both fluid and solute control but cannot tolerate rapid fluid shifts associated with hemodialysis
continuous venovenous hemodiafiltration (CVVHDF) OR continuous venovenous hemodialysis (CVVHD)
removes both fluids and solutes. requires both dialysate and replacement fluid (same as CVVHDF)
continuous venovenous hemodialysis (CVVHD)
removes both fluid and solutes requires replacement fluid
continuous venovenous hemofiltration (CVVH)
CRRT types
continuous venovenous hemofiltration (CVVH) slow continuous ultrafiltration (SCUF) continuous venovenous hemodialysis (CVVHD) continuous venovenous hemodiafiltration (CVVHDF)
CRRT vs hemodialysis CRRT is __________ rather than __________ does not require __________ causes less hemodynamic __________ does not require constant monitoring by a specialized HD nurse but does require a __________ does not require complicated HD __________ but a blood pump is needed for ___________ therapies
continuous; intermitent dialysate instability (hypotension) trained ICU nurse equipment venovenous
two types of CRRT that use dialysate
CVVHD and CVVHDF
the idea behind CRRT is to dialyze the patient in a more __________ way
physiologic (24hrs)
reductions in __________ and __________ are expected but there should be little change in __________ pressure
central venous pressure pulmonary artery pressure mean arterial pressure
removes both fluids and solutes. requires both dialysate and replacement fluid (same as CVVHD)
continuous venovenous hemodiafiltration (CVVHDF)
access site for CRRT
double lumen catheter in the jugular or femoral vein
CRRT can be used in conjunction with
hemodialysis
life threatening manifestations of uremia that would contraindicate CRRT
hyperkalemia pericarditis
CRRT contraindications
life-threatening manifestations of uremia requiring rapid treatment
simplified version of continuous venovenous hemofiltration (CVVH). Removes fluid but no replacement fluid is required
slow continuous ultrafiltration (SCUF)
CRRT provides a means by which _________ and fluids are removed while the __________ status and __________ are adjusted slowly and continuously in a hemodynamically unstable patient
uremic toxins acid-base electrolytes
nursing interventions for CRRT include: obtaining daily __________ daily monitoring and documenting __________ to ensure adequate __________ assess hourly __________, __________, __________ status
weights lab values; fluid and electrolyte balance I&O; vitals; hemodynamic status