Continuous renal replacement therapy (CRRT) allows gradual, precise removal of excess fluid and solutes. Special considerations are necessary for children who require CRRT because of their smaller circulating blood volumes and the potential for hemodynamic instability associated with the initiation of CRRT. In critically ill children, the CRRT circuit is often primed with blood rather than saline to prevent excessive hemodilution. Two innovative techniques have been designed to limit repeated exposure to donated blood, reduce hemodynamic instability associated with priming of the circuit with blood, and limit interruptions in CRRT. A circuit-to-circuit exchange technique offers a safe, effective alternative method for CRRT circuit changes in small children and infants. A concurrent technique that combines CRRT with plasmapheresis is effective in preventing interruptions of therapy when patients require multiple modes of supportive treatment.
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1 February 2011
Pediatric Care|
February 01 2011
Innovative Techniques to Decrease Blood Exposure and Minimize Interruptions in Pediatric Continuous Renal Replacement Therapy
Dawn M. Eding, RN, BSN, CCRN;
Dawn M. Eding is the nursing coordinator of the pediatric continuous renal replacement therapy program at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Lindsey R. Jelsma, Caryn J. Metz, and Vanessa S. Steen are members of the core nursing team for pediatric continuous renal replacement therapy at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Jenifer M. Wincek is a clinical nurse specialist at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan
Corresponding author: Dawn M. Eding, rn, bsn, ccrn, Helen DeVos Children’s Hospital, 100 Michigan Street, NE, Grand Rapids, MI 49503 (e-mail: [email protected]).
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Lindsey R. Jelsma, RN, BSN, CCRN;
Lindsey R. Jelsma, RN, BSN, CCRN
Dawn M. Eding is the nursing coordinator of the pediatric continuous renal replacement therapy program at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Lindsey R. Jelsma, Caryn J. Metz, and Vanessa S. Steen are members of the core nursing team for pediatric continuous renal replacement therapy at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Jenifer M. Wincek is a clinical nurse specialist at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan
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Caryn J. Metz, RN, BSN, CCRN;
Caryn J. Metz, RN, BSN, CCRN
Dawn M. Eding is the nursing coordinator of the pediatric continuous renal replacement therapy program at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Lindsey R. Jelsma, Caryn J. Metz, and Vanessa S. Steen are members of the core nursing team for pediatric continuous renal replacement therapy at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Jenifer M. Wincek is a clinical nurse specialist at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan
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Vanessa S. Steen, RN, BSN;
Vanessa S. Steen, RN, BSN
Dawn M. Eding is the nursing coordinator of the pediatric continuous renal replacement therapy program at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Lindsey R. Jelsma, Caryn J. Metz, and Vanessa S. Steen are members of the core nursing team for pediatric continuous renal replacement therapy at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Jenifer M. Wincek is a clinical nurse specialist at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan
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Jenifer M. Wincek, RN, MSN
Jenifer M. Wincek, RN, MSN
Dawn M. Eding is the nursing coordinator of the pediatric continuous renal replacement therapy program at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Lindsey R. Jelsma, Caryn J. Metz, and Vanessa S. Steen are members of the core nursing team for pediatric continuous renal replacement therapy at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan.Jenifer M. Wincek is a clinical nurse specialist at Helen DeVos Children’s Hospital, Spectrum Health, in Grand Rapids, Michigan
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Crit Care Nurse (2011) 31 (1): 64–71.
Citation
Dawn M. Eding, Lindsey R. Jelsma, Caryn J. Metz, Vanessa S. Steen, Jenifer M. Wincek; Innovative Techniques to Decrease Blood Exposure and Minimize Interruptions in Pediatric Continuous Renal Replacement Therapy. Crit Care Nurse 1 February 2011; 31 (1): 64–71. doi: https://doi.org/10.4037/ccn2011757
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