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Critical Care
Erschienen in: Critical Care 4/2007

01.08.2007 | Review

Clinical review: Patency of the circuit in continuous renal replacement therapy

verfasst von: Michael Joannidis, Heleen M Oudemans-van Straaten

Erschienen in: Critical Care | Ausgabe 4/2007

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Abstract

Premature circuit clotting is a major problem in daily practice of continuous renal replacement therapy (CRRT), increasing blood loss, workload, and costs. Early clotting is related to bioincompatibility, critical illness, vascular access, CRRT circuit, and modality. This review discusses non-anticoagulant and anticoagulant measures to prevent circuit failure. These measures include optimization of the catheter (inner diameter, pattern of flow, and position), the settings of CRRT (partial predilution and individualized control of filtration fraction), and the training of nurses. In addition, anticoagulation is generally required. Systemic anticoagulation interferes with plasmatic coagulation, platelet activation, or both and should be kept at a low dose to mitigate bleeding complications. Regional anticoagulation with citrate emerges as the most promising method.
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Metadaten
Titel
Clinical review: Patency of the circuit in continuous renal replacement therapy
verfasst von
Michael Joannidis
Heleen M Oudemans-van Straaten
Publikationsdatum
01.08.2007
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 4/2007
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc5937

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