title: Continuous Renal Replacement Therapy and Anticoagulation: What Are the Options?
abstract: Continuous renal replacement therapy is currently used as a standard treatment for acute kidney injury in the intensive care unit, particularly for patients with unstable hemodynamic status. Because this therapy is continuous, for days or weeks, and the extracorporeal blood circuit is large, the circuit is prone to clotting. Several methods of keeping the extracorporeal circuit patent are available, including heparin infusion, flushes with physiological saline, use of thrombin inhibitors, and citrate. This article reviews methods for continuous renal replacement therapy, anticoagulation, efficacy, and implications for bedside critical care.
authors.affiliation: Susan Dirkes is a staff nurse in the surgical intensive care unit and the progressive care unit at the University of Michigan Health System, Ann Arbor, Michigan.Rob Wonnacott is the clinical educator in the surgical intensive care unit and lead instructor for the adult CRRT program at the University of Michigan Health System. susandirkes@gmail.com.
authors.forename: Susan
authors.initials: S
authors.lastname: Dirkes
authors.affiliation: Susan Dirkes is a staff nurse in the surgical intensive care unit and the progressive care unit at the University of Michigan Health System, Ann Arbor, Michigan.Rob Wonnacott is the clinical educator in the surgical intensive care unit and lead instructor for the adult CRRT program at the University of Michigan Health System.
authors.forename: Rob
authors.initials: R
authors.lastname: Wonnacott
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D064648:Critical Care Nursing / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D017582:Renal Replacement Therapy / Q000379:methods*; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000925:Anticoagulants