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