Understanding the continuous renal replacement therapy circuit for acute renal failure support: a quality issue in the intensive care unit.
Delivery of renal replacement therapy is now a core competency of intensive care nursing. The safe and effective delivery of this form of therapy is a quality issue for intensive care, requiring an understanding of the principles underlying therapy and the functioning of machines used. Continuous hemofiltration, first described in 1977, used a system where blood flowed from arterial to venous cannulas through a small-volume, low-resistance, and high-flux filter. Monitoring of these early systems was limited, and without a machine interface, less nursing expertise was required. Current continuous renal replacement therapy machines offer user-friendly interfaces, cassette-style circuits, and comprehensive circuit diagnostics and monitoring. Although these machines conceal complexity behind a user-friendly interface, it remains important that nurses have sufficient knowledge for their use and the ability to compare and contrast circuit setups and functions for optimal and efficient treatment.
Intensive Care Unit, DBL1S, Prince of Wales Hospital, Barker St, Randwick, New South Wales 2031, Australia. martin.boyle@sesiahs.health.nsw.gov.au
Martin
M
Boyle
Ian
I
Baldwin
D058186:Acute Kidney Injury / Q000628:therapy*; D003422:Critical Care; D005440:Fluid Therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D009517:New South Wales; D011787:Quality of Health Care / Q000592:standards*; D017582:Renal Replacement Therapy / Q000295:instrumentation / Q000379:methods*