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Chapter 2: Important information
2.6.3
Treatment modes and fields of application
SCUF
Pre CVVH, Post CVVH,
Pre-Post CVVH, CVVHD,
Pre CVVHDF, and
Post CVVHDF
Haemoperfusion
Plasma separation
2.6.4
Anticoagulation of the extracorporeal blood circuit
Systemic anticoagulation
Regional anticoagulation
with citrate
2-4
– Diuretic resistant fluid retention, especially in the event of cardiac
insufficiency or pulmonary oedema.
– Acute renal insufficiency.
– Removal of toxic metabolic products.
– Treatment of life-threatening electrolyte imbalance,
e.g., hyperkalaemia.
– Correction of the acid-base status, e.g., metabolic acidosis.
– Diuretic resistant fluid retention, especially in the event of cardiac
insufficiency or pulmonary oedema.
– Removal of toxic substances, also protein-bound substances by
adsorption.
– Removal of plasma, e.g.,
for removing pathological immunoglobulins,
for removing protein-bound toxins or for administering sufficient
quantities of physiological proteins contained in donor plasma.
Most patients need an anticoagulant to prevent their blood from
coagulating in the extracorporeal blood circuit. This can be performed
systemically, i.e., also in the patient's body, or regionally limited to the
extracorporeal blood circuit.
The integrated heparin pump can be used for the continuous
anticoagulation of the blood.
Warning
Any treatment in connection with citrate anticoagulation may only be
performed in intensive care units or under similarly close monitoring.
The Ci-Ca function integrated in the system permits regional
anticoagulation in the extracorporeal blood circuit with citrate. Citrate
anticoagulation can be used on most patients with CRRT indication.
Exceptions (see chapter 2.6.7 on page 2-6).
This function is intended to be used for adults and can be especially
efficient in the following cases:
– Patients with a bleeding risk, that is, patients on whom systemic
anticoagulation cannot be used at all or only to a degree that is
inadequate for continuous renal replacement therapy.
– Patients with whom the haemofilter rapidly and repeatedly becomes
clogged when different anticoagulation methods are used.
Fresenius Medical Care multiFiltrate IFU-EN-UK 15A-2015
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