A quick reference guide to haemofiltration and renal failure March ...

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SCUF Slow Continuous Ultrafiltration. SCUF is not associated with fluid replacement and is therefore the simplest form of CRRT. The primary aim of SCUF is to achieve safe and effective management of fluid overload. SCUF can be either veno-venous (VV) or arterio-venous (AV). • In V-VSCUF the blood is pumped through a filter by a pump. • In A-VSCUF the blood is pumped through a filter by the patients own blood pressure. (Bellomo, Ronco and Mehta, 1996:S3) A-V SCUF V-V SCUF A V V + pump V UF UF (Bellomo, Ronco and Mehta, 1996:S4) A – artery, V – vein, UF – ultra filtrate. 8
CVVHF Continuous Veno-Venous Haemofiltration Arterial cannulation carries added risks of bleeding, infection and vessel damage. For this reason, the development of pumps to achieve continuous haemofiltration using venous access only, prevails in most ICUs. A double lumen catheter is used to access a central vein, usually femoral, subclavian or jugular. Blood is driven though a highly permeable membrane (haemofilter) by the peristaltic pump. This is achieved through an extracorporeal circuit, whereby blood is removed through one lumen (called the arterial) and then returned to circulation via the other lumen (called the venous lumen). Ultrafiltrate generated as a result of movement across the membrane is replaced with appropriate fluid to achieve volume control and blood purification. The addition of replacement fluid may be pre- filter (predilution) or post-filter (postdilution). (Bellomo, Ronco and Mehta, 1996:S3) and (Bellomo in Eo, 1998:367). V + pump V UF V – vein, R – replacement fluid, UF – ultrafiltrate. R 9
Page 1 and 2: A quick reference guide to haemofil
Page 3 and 4: Acute renal failure (ARF) is a comm
Page 5 and 6: Glomerular Filtration; blood flows
Page 7: CRRT, or continuous renal replaceme
Page 11 and 12: CVVHD Continuous Veno-Venous Haemod
Page 13 and 14: Molecules are measured in daltons (
Page 15 and 16: FILTRATION Filtration is defined as
Page 17 and 18: CONVECTION Convection is defined as
Page 19 and 20: MANIPULATION OF THESE H PRINCIPLES
Page 21 and 22: • A double lumen catheter, also k
Page 23 and 24: AIM - to prevent the filter and the
Page 25 and 26: MOST COMMONLY USED ANTICOAGULANT TH
Page 27 and 28: SALINE FLUSHES • In patients that
Page 29 and 30: There is restriction of movement of
Page 31 and 32: Bicarbonate is unstable in solution
Page 33 and 34: BASELINE OBSERVATIONS to establish
Page 35 and 36: NORMAL BLOOD VALUES Na 135 - 145 mm
Page 37 and 38: While machines involved in CRRT dif
Page 39 and 40: The Aquariius Manufactured by Edwar
Page 41 and 42: TRANSMEMBRANE PRESSURE ALARM TMP ha
Page 43 and 44: Line kinked /clamped Remove kink /
Page 45 and 46: If UF is coloured, the membrane is
Page 47: we know? American Journal of Kidney

A quick reference guide to haemofiltration and renal failure March ...

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