Get Orlando Health Self Learning Packet 2006 Prinicpal Of Continouous Reneal Replacement Form

The goals of CRRT include (i) clearance of uremic toxins, (ii) correction of electrolytes disturbance, (iii) acid-base balance, (iv) hemodynamic stabilization, (v) fluid balance, (vi) nutritional support, and (vii) removal and/or modulation of inflammatory mediators in septic patients.

Check blood urea nitrogen and creatinine levels at least daily to assess CRRT efficacy. Routinely monitor the patient's complete blood counts to check for unintended blood loss in case the CRRT circuit suddenly clots.

Continuous renal replacement therapy (CRRT) is commonly used to provide renal support for critically ill patients with acute kidney injury, particularly patients who are hemodynamically unstable.

Four essential nursing principles for CRRT are reviewed (1) the importance of continuous assessment of the indications to influence the appropriate mode; (2) ensuring good vascular access; (3) the avoidance of unnecessary interruptions and (4) the prevention of complications.

Providing energy 25-35 kcal/kg/d with a carbohydrate/lipid ratio of 60-70/30-40 and protein 1.5-1.8 g/kg/d is recommended during continuous renal replacement therapy. Supplemental vitamin B(1) (100 mg/d), vitamin C (250 mg/d), and selenium (100 mcg/d) are also recommended.

CRRT is based on four main physiologic principles. These are (a) diffusion, (b) ultrafiltration, (c) convection, and (d) adsorption. In clinical practice, there is more than one principle implemented in achieving the goals of required treatment (e.g., diffusion, ultrafiltration, and convection).

The goals of CRRT are to: Maintain fluid balance. Maintain electrolyte balance.

Basic mechanisms of fluid transport and solute removal (ultrafiltration, diffusion, convection, and adsorption) and the factors influencing these processes in CRRT are described.