Choice
Blood Flow Rate
  • Blood flow rates are typically slower than in intermittent dialysis (150-200mL/min)
  • Generally, the faster the flow, the more efficient the dialysis.
Dialysate or Replacement Fluid Composition
  • The specific fluid is based on the metabolic parameters of the patient, including the patient’s acid-base status and serum potassium concentration
  • Typical flow rates range from 500mL/min to 800mL/min
Replacement Fluid Pre/Post Dilution Ratio
  • The proportion of replacement fluid delivered before or after the filter
  • Typically started with 30% pre- and 70% post-dilution
Effluent Rate (Dose)
  • Dosing is weight based and is typically prescribed at a dose ranging from 20 mL/kg/hr to 35 mL/kg/hr
Fluid Removal Goal
  • This is the amount of fluid to be removed from the patient over the course of the session
  • Determined by clinical assessment of the patient’s volume status.
Anticoagulation
  • Clotting within the dialysis circuit can result in significant blood loss
  • Heparin is typically used unless the patient has a contraindication
  • An alternative to heparin anticoagulation often used with CRRT is regional citrate anticoagulation, in which citrate is administered to chelate calcium, a critical cofactor in the clotting cascade