Difference between revisions of "CRRT (Continuous Renal Replacement Therapy)"
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** Clearance of different size of solute similar until the size of the solute reaches with size of the pores | ** Clearance of different size of solute similar until the size of the solute reaches with size of the pores | ||
** Overall CVVH with higher clearance rate than CVVHD for solutes 1,000 to 20,000 Daltons | ** Overall CVVH with higher clearance rate than CVVHD for solutes 1,000 to 20,000 Daltons | ||
[[File:Img 1.png|thumb|Figure 1: | [[File:Img 1.png|thumb|Figure 1: Types of CRRT (Recreated based on Tandukar 2019 & Asahi Kasei Medical Co.)]] | ||
'''Main types (see figure 1 for diagrams):''' | '''Main types (see figure 1 for diagrams):''' | ||
Revision as of 13:38, 4 May 2024
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| Anesthetic management |
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Provides renal support to patients. Usually veno-venous, but arterio-venous exists too (not covered here).
Mechanisms and types
Solute removal mechanisms:
- Diffusion
- Accomplished by passive movement of solute across a membrane
- Efficient clearance of low-molecular-weight solutes (< 500-1,500 Daltons)
- Clearance decreases with increasing molecular weight of solute
- Convection
- Accomplished by active movement of solute (due to a pressure gradient) across a membrane
- Limited primarily by size of pores in membrane
- Clearance of different size of solute similar until the size of the solute reaches with size of the pores
- Overall CVVH with higher clearance rate than CVVHD for solutes 1,000 to 20,000 Daltons
Main types (see figure 1 for diagrams):
- SCUF (Slow continuous ultrafiltration)
- Convection
- Mainly fluid removal
- CVVH (Continuous venovenous hemofiltration)
- Convection
- CVVHD (Continuous venovenous hemodialysis)
- Diffusion
- CVVHDF (Continuous venovenous hemodiafiltration)
- Combination of convection and diffusion
Anesthetic implications
Preoperative optimization
Intraoperative management
Postoperative management
Related surgical procedures
Pathophysiology
Signs and symptoms
Diagnosis
Treatment
Medication
Surgery
Prognosis
References
Tandukar S, Palevsky PM. Continuous Renal Replacement Therapy: Who, When, Why, and How. Chest. 2019 Mar;155(3):626-638. doi: 10.1016/j.chest.2018.09.004. Epub 2018 Sep 25. PMID: 30266628; PMCID: PMC6435902.
Continuous Renal Replacement Therapy (CRRT) | Asahi Kasei Medical Co., Ltd. (n.d.). https://www.asahi-kasei.co.jp/medical/en/apheresis/product/crrt/about/cure.html
Cronin B, O'Brien EO. Intraoperative Renal Replacement Therapy: Practical Information for Anesthesiologists. J Cardiothorac Vasc Anesth. 2022 Aug;36(8 Pt A):2656-2668. doi: 10.1053/j.jvca.2021.10.002. Epub 2021 Oct 8. PMID: 34750060.