CRRT is a type of blood purification therapy used to treat AKI patients. During this therapy, a patient's blood is passed through a specific filter that eliminates fluid and uremic toxins, allowing clean blood to be returned to the body. For critically ill patients with acute kidney damage, continuous renal replacement therapy (CRRT) is frequently utilised to provide renal support, especially for hemodynamically unstable patients.
Only a few methods can be used continuous venovenous hemofiltration, which primarily uses convective solute clearance; continuous venovenous hemodialysis, which primarily uses diffusive solute clearance; and continuous venovenous hemodiafiltration, which combines dialysis and hemofiltration. The current research compares CRRT with various modalities of renal support. It addresses the indications for starting renal replacement therapy and the dose and technical aspects of CRRT management.
CRRT treatment in Hebbal, Bangalore is a slower dialysis technique that puts less strain on the heart. Instead of taking four hours, CRRT is performed 24 hours a day to gradually and constantly remove waste products and fluid from the patient. To keep the dialysis circuit from clotting, specific anticoagulation is required.
Six therapeutic devices are required to execute CRRT on a patient,
Blood purification machine: the equipment pumps blood, regulates blood flow and contains software to monitor therapeutic delivery carefully.
Dialysate is a fluid that removes toxins from the filter.
Replacement fluid is a specific, sterile fluid used to flush toxins from the body and replenish electrolytes, other blood constituents, and volume lost during filtration.
Filter: a machine component that eliminates uremic poisons and fluid.
Anticoagulation method: a medicine that helps blood flow through the system, reducing the likelihood of clotting in the filter
Blood warmer: effectively keeps a patient's blood temperature stable throughout blood purifying therapy.
CRPT can mainly be of three types. The applied type of the procedure depends on several aspects of the physicians' expertise, primarily the patient’s condition and needs. The three types of CRPT procedures are as follows,
Membranes are synthetic and biocompatible layers used in CRPT to remove as much water and waste from the body as feasible. Continuous renal replacement therapy (CRPT) filters blood using a hemofilter and high-flow dialysers, and proteins are readily absorbed and purified through these membranes. Cytokines can be reduced or removed in size via dialysis and hemofiltration. If cytokines are not released, they can induce inflammation and severe renal issues in the body.
Dialysate fluids are used in continuous venovenous haemodialysis to eliminate waste products. Dialysate fluids improve the chances of getting better results during dialysis. The elimination of molecular wastes is aided by continuous venous haemodialysis. Dialysis fluids are available from various sources, although they are less expensive and more effective than other types of dialysis fluids. Electrolytes in these fluids keep blood cells healthy and resistant.
The various CRRT modalities can use diffusion, convection, or solute clearance. Unlike IHD, CRRT is conducted continuously for 24 hours a day, with a typical blood flow of 100 to 300 mL/min and a dialysate flow of 17 to 40 mL/min if a diffusive CRRT modality is used. It is most typically conducted using a venovenous vascular approach. The most often used CRRT modalities are continuous venovenous hemofiltration (CVVH), continuous venovenous hemodialysis (CVVHD), and continuous venovenous hemodiafiltration. Solute clearance happens by convection in CVVH, and no dialysate is used. The rate of ultrafiltration is a primary driver of convective clearance. Intravenous "replacement fluid" is administered to replace the eliminated excess volume and refill desired solutes.
The benefits of CRRT include improved hemodynamic tolerance due to slower ultrafiltration and solute elimination. The progressive continuous volume withdrawal simplifies volume control and enables the administration of drugs and nourishment with less concern for volume overload. Because it is a constant modality, solute concentrations fluctuate less over time, allowing for improved regulation of azotemia, electrolytes, and acid-base status. It does not cause an increase in intracranial pressure like IHD. The main disadvantages of CRRT are access and filter clotting and the resulting requirement for anticoagulation. Book an appointment at Manipal Hospitals to know more about the treatment with the help of best doctors in Bangalore.