Solutes to be Removed from the Plasma
• Hemofiltration is better at removing middle molecules
• Hemodialysis better at removing small molecules
Patients Cardiovascular and Neurological Status
• CRRT causes less rapid fluid shifts and is the preferred option if there is any degree of cardiovascular instability
• CRRT may be associated with better cerebral perfusion in patients with an acute brain injury or fulminant hepatic failure
Availability of Resources
• CRRT is more labour intensive and more expensive than IHD
• Availability of equipment may dictate the form of RRT.
Clinicians Experience
• It is wise to use a form of RRT that is familiar to all the staff involved
Other Specific Clinical Considerations
• Convective modes of RRT may be beneficial if the patient has septic shock
• CRRT can aid feeding regimes by improving fluid management