• Critical care nurse · Apr 2016

    Review

    Continuous Renal Replacement Therapy and Anticoagulation: What Are the Options?

    • Susan Dirkes and Rob Wonnacott.
    • Susan Dirkes is a staff nurse in the surgical intensive care unit and the progressive care unit at the University of Michigan Health System, Ann Arbor, Michigan.Rob Wonnacott is the clinical educator in the surgical intensive care unit and lead instructor for the adult CRRT program at the University of Michigan Health System. susandirkes@gmail.com.
    • Crit Care Nurse. 2016 Apr 1; 36 (2): 34-41.

    AbstractContinuous renal replacement therapy is currently used as a standard treatment for acute kidney injury in the intensive care unit, particularly for patients with unstable hemodynamic status. Because this therapy is continuous, for days or weeks, and the extracorporeal blood circuit is large, the circuit is prone to clotting. Several methods of keeping the extracorporeal circuit patent are available, including heparin infusion, flushes with physiological saline, use of thrombin inhibitors, and citrate. This article reviews methods for continuous renal replacement therapy, anticoagulation, efficacy, and implications for bedside critical care. ©2016 American Association of Critical-Care Nurses.

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