Continuous Renal Replacement Therapy (CRRT)

CRRT functions by continuously filtering the blood to remove waste products and excess fluids while maintaining electrolyte and acid-base balance. It is performed using a specialized machine that employs a hemofilter to purify blood through one of four CRRT modalities:

• Continuous Venovenous Hemofiltration (CVVH) : Uses convection to remove large amounts of solutes and fluids.
• Continuous Venovenous Hemodialysis (CVVHD) : Uses diffusion to clear smaller solutes effectively.
• Continuous Venovenous Hemodiafiltration (CVVHDF) : A combination of CVVH and CVVHD for optimal clearance.
• Slow Continuous Ultrafiltration (SCUF) : Removes excess fluid without significant solute removal.

• Patient Positioning : Ensure patient comfort and appropriate positioning for vascular access.
• Vascular Access Placement : Insert a double-lumen catheter into a large vein under ultrasound guidance.
• Priming the Circuit: The CRRT machine is primed with saline or heparinized solution to remove air and prepare the blood tubing.
• Machine Setup : Connecting the CRRT circuit to the patient, adjusting the blood flow rate, ultrafiltration rate, and dialysate flow.
• Initiating CRRT : Blood is withdrawn from the patient, passed through the hemofilter, and returned via the venous access.
• Monitoring : Continuous assessment of vital signs, fluid balance, electrolytes, and filter function.
• Adjustments : Based on patient response, parameters such as fluid removal rates, anticoagulation, and replacement fluid composition may be modified.
• Termination : Once the therapy session is complete or no longer needed, the circuit is flushed, and the catheter is either removed or maintained for future use.

CRRT functions by continuously filtering the blood to remove waste products and excess fluids while maintaining electrolyte and acid-base balance. It is performed using a specialized machine that employs a hemofilter to purify blood through one of four CRRT modalities:

CRRT, like any medical procedure, carries potential risks and complications, including:

• Hypotension : Due to excessive fluid removal, leading to shock.
• Electrolyte Imbalance : Hypokalemia, hypophosphatemia, or metabolic acidosis/alkalosis.
• Bleeding : Due to anticoagulation use, leading to increased bleeding risk.
• Catheter-Related Infections : Septicemia or localized infections at the catheter site.
• Clotting of the Circuit : Due to inadequate anticoagulation, leading to therapy interruption.
• Hypothermia: As blood continuously circulates outside the body, temperature loss can occur.