The coagulation system in the critically ill patient with acute renal failure and the effect of an extracorporeal circuit.
Continuous renal replacement therapy (CRRT) has been advocated as the treatment of choice in critically ill patients with renal failure. However, to be as effective as intermittent hemodialysis in terms of small molecule clearance, the extracorporeal CRRT circuit must operate continuously, 24 hours a day, day after day. This review examines both patient and extracorporeal factors that may lead to premature clotting within the CRRT circuit, and approaches that may reduce extracorporeal clotting.
Davenport
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Department of Renal Medicine and Transplantation, The Royal Free Hospital, London, United Kingdom. davenport@rfhsm.ac.uk
D058186:Acute Kidney Injury / Q000097:blood* / Q000628:therapy*; D001166:Arteriovenous Shunt, Surgical; D001777:Blood Coagulation; D019774:Blood Coagulation Factor Inhibitors; D001792:Blood Platelets; D016638:Critical Illness; D004730:Endothelium, Vascular; D005342:Fibrinolysis; D006440:Hemofiltration; D006801:Humans; D006435:Renal Dialysis; D017582:Renal Replacement Therapy / Q000295:instrumentation / Q000379:methods
D019774:Blood Coagulation Factor Inhibitors