Use of Saline Flush to Prevent Filter Clotting in Continuous Renal Replacement Therapy without Anticoagulant
Sirirat Panphanpho RN*, Saowanee Naowapanich RN*, Ranistha Ratanarat MD**
Affiliation : * Division of Medical and Psychiatric Nursing, Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Devision of Critical Care Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : This study aims to compare filter life between saline flushed and non-saline flushed strategies in critically ill
patients at high risk of bleeding who are undergoing CRRT without anticoagulation.
Material and Method: A cohort of 121 critically ill patients with severe acute kidney injury (AKI) requiring CRRT in the
medical intensive care unit (ICU) and cardiac care unit (CCU) of a tertiary care academic center were included. 78 of them
used saline flushed through CRRT circuit.
Results : There was no significant difference between the two groups of treated patients in baseline characteristics, including
the extent of coagulopathy and platelet count. Mean circuit survival was 21.2 h for circuits using saline flush and 20.4 h for
those using non-saline flush (p = 0.8).The Kaplan-Meier curves revealed no difference in circuit survival time between saline
flushed and non-saline flushed groups (p = 0.8).
Conclusion : The use of saline flush into pre-filter site of CRRT circuit does not provide any benefit on circuit clotting
prevention in high-risk of bleeding patients requiring CRRT without anticoagulant.
Keywords : Critical illness, Acute renal failure, Acute kidney injury, Hemofiltration, Continuous renal replacement therpy, Anticoagulant
