ABSTRACT
Continuous renal replacement therapies (CRRTs) avoid aggressive reductions in blood pressure, so continuous veno-venous haemofiltration/haemodiafiltration is the main CRRT used in intensive care units. Continuous veno-venous haemofiltration uses only ultrafiltration and convection. Continuous veno-venous haemodiafiltration uses: ultrafiltation, convection, and dialysis. Haemofilters use high blood flow, so a large double-lumen cannula is inserted into a large vein – usually internal jugular or femoral. Hypotension can occur quickly, especially when commencing filtration, so haemodynamic status should be closely monitored, and blood pumps commenced at 100 ml/hr. Haemofiltration in intensive care unit is largely used as a means for normalising blood chemistry and/or removing fluid while underlying diseases, such as sepsis, are resolved. Nurses who have not used haemofiltration equipment should take every opportunity to learn how to manage it before caring for patients being haemofiltered. Duration of haemofiltration is therefore usually limited to a few days.
