Fluid Management in CRRT
The volume of hourly ultrafiltrate removed depends on an hourly fluid balance calculation and assessment of patient’s hemodynamic and fluid status. Hourly fluid goal calculation is the non-CRRT intake, plus fluid loss ordered by the physician, minus non-CRRT output. The system infuses and removes fluid after the fluid balance is calculated, and the desired volumes are input into the system. The system monitors the volume of replacement fluid, dialysate, and the volume of fluid removed by the use of scales.
Potential Complications of CRRT
Air embolus: This can occur if the patient receives air in the blood returned. The system has air detectors that are highly sensitive even to micro-bubbles. Alarms can occur if the system was not thoroughly primed or if any port is loose. Air embolus can occur if the return line connection is loose on the patient’s side, in which case the air enters the system after the bubble detector. This complication can be prevented by ensuring integrity of the circuit and by continuous monitoring of the air detectors.
Blood …show more content…
CVP represents the pressure of the right atrium (RA), which is measured using a catheter placed in the RA. CVP values can be obtained from any central line catheter placed in the internal jugular vein (IJ), subclavian vein (SC), or femoral vein, or from a peripherally inserted central catheter. During insertion of IJ or SC, the patient is placed in the Trendelenburg position to allow the neck blood vessels to fill with blood. The patient will be asked to take a deep breath and hold it anytime there is a potential risk of air entering the insertion site or through the needle. In the case of a suspected air embolism, the patient is asked to stay in the left lateral position with the head low to allow the air to escape from the right ventricle outflow tract to the apex, where it is absorbed or can be
The volume of hourly ultrafiltrate removed depends on an hourly fluid balance calculation and assessment of patient’s hemodynamic and fluid status. Hourly fluid goal calculation is the non-CRRT intake, plus fluid loss ordered by the physician, minus non-CRRT output. The system infuses and removes fluid after the fluid balance is calculated, and the desired volumes are input into the system. The system monitors the volume of replacement fluid, dialysate, and the volume of fluid removed by the use of scales.
Potential Complications of CRRT
Air embolus: This can occur if the patient receives air in the blood returned. The system has air detectors that are highly sensitive even to micro-bubbles. Alarms can occur if the system was not thoroughly primed or if any port is loose. Air embolus can occur if the return line connection is loose on the patient’s side, in which case the air enters the system after the bubble detector. This complication can be prevented by ensuring integrity of the circuit and by continuous monitoring of the air detectors.
Blood …show more content…
CVP represents the pressure of the right atrium (RA), which is measured using a catheter placed in the RA. CVP values can be obtained from any central line catheter placed in the internal jugular vein (IJ), subclavian vein (SC), or femoral vein, or from a peripherally inserted central catheter. During insertion of IJ or SC, the patient is placed in the Trendelenburg position to allow the neck blood vessels to fill with blood. The patient will be asked to take a deep breath and hold it anytime there is a potential risk of air entering the insertion site or through the needle. In the case of a suspected air embolism, the patient is asked to stay in the left lateral position with the head low to allow the air to escape from the right ventricle outflow tract to the apex, where it is absorbed or can be