CRRT (Continuous Renal Replacement Therapy)

CRRT (Continuous Renal Replacement Therapy)

Introduction

This essay is based on Continuous Renal Replacement Therapy (CRRT). Continuous renal replacement therapy is a medical procedure used for diagnoses such as acute renal failure, acute tubular necrosis and hepatorenal syndrome. CRRT has been a step forward in the management of critically ill patients with acute renal failure (ARF), it is a common complication in intensive care units (ICU), associating it to a high rate of mortality ranging from 50-70%. Critically ill patients often do not tolerate sudden changes in osmolarity and volume induced by conventional hemodialysis, and demand high volumes of intravenous fluids continuously, handling difficult periods. The option of peritoneal dialysis presents a number of difficulties and limitations that often make it not feasible, so the CRRT is the best option for these patients.Several studies have shown that continuous replacement techniques are associated with a better metabolic control, compared with intermittent techniques. An important advantage of continuous replacement techniques is that they can handle large amounts for infusion of antibiotics, enteral and parenteral nutrition, and drugs, without changing the balance of fluids from patients (Nurmohamed, 2012).

Implications and Benefits of Continuous Renal Replacement Therapy (CRRT)

The continuous renal replacement techniques (CRRT) are widely used in intensive care units. The most abundant and dangerous entity in this environment is acute renal failure (ARF). First, one must recognize the physical principles used in the different modalities of CRRT that allow solute clearance and fluid removal, these are:

Convection (hemofiltration): The movement of water through a membrane permeability which allows the extraction of solutes dissolved in it, which will result in a loss of total body solute, but not a decrease in its concentration. To achieve this reduction, it must reset perfuse a liquid, balancing ultrafiltered plasma volume.

Convection + Diffusion (hemodiafiltration): Elimination of solutes in favor ...