09.04 Continuous Renal Replacement Therapy

Nursing Points

General

1. CCRT
   1. Continuous Renal Replacement Therapy
      1. Continuous dialysis therapy
      2.   Not as aggressive as hemodialysis
      3. Removes volume and solutes slowly
      4. Corrects electrolytes and metabolic abnormalities
      5. Maintain fluid balance
   2. CCRT is used in unstable patients with:
      1. Fluid overload
      2. Acute renal failure
      3. Chronic renal failure
      4. Electrolyte imbalance
      5. Drug overdose
   3. Methods for performing CCRT
      1. Arteriovenous
      2.   Venovenous
         1. Most common
         2. Blood pump forces blood from patient to filter
            1. Ensures consistent pressure in circuit and in hemofilter
         3. Performed in four ways
            1. SCUF =Slow Continuous Ultrafiltration
               1. Primary goal = fluid removal
            2. CVVH=Continuous Venovenous Hemofiltration
               1.   Fluid volume management
               2. Moderate solute removal
            3. CVVHD=Continuous Venovenous Hemodialysis
               1.   Fluid volume management
               2. Greater solute removal
            4. CVVHDF= Continuous Venovenous Hemodiafiltration
               1. Maximal fluid and solute removal