Tasty Morsels of Critical Care Tasty Morsels of Critical Care 070 | CRRT Modes
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Mar 13, 2023 Delving into CRRT modes in critical care, the podcast distinguishes between IHD and CRRT, discussing CVVH, CVVHD, and CVVHDF. It explores scuff and sled as modes of renal replacement therapy, highlighting ultrafiltration processes and solute clearance rates.
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Diffusion Versus Convection Matter
- CRRT and IHD differ not just by duration but by fundamental solute and fluid transport mechanisms across membranes.
- Dialysis relies on diffusion while ultrafiltration relies on convection driven by pressure gradients.
How CVVH Works
- CVVH uses convection: hydrostatic pressure pushes plasma water through a membrane carrying solutes with it.
- The ultrafiltrate collects like urine and removes water, potassium, and urea efficiently but requires replacement fluid to avoid hypovolemia.
CVVHD Uses Diffusion And Dialysate
- CVVHD uses countercurrent dialysate and diffusion to clear solutes down concentration gradients.
- Water follows solute movement, and dialysate flow rates in CRRT are much lower than in intermittent HD.