I just realized that in the first sentence of your first post says they use the same docs. Sorry 'bout that. :imbar
As to which device is best, I don't know, but we use the PRISMA
system (at that link, drag your mouse over "Intensive Care Products" on the left of your screen and click "Continuous Renal Replacement Therapies" to see what I'm talking about). The site mentions a syringe feature for anticoagulation, but we use citrate on an IV pump.
CVVH can be labor intensive as lee1 states, but PRISMA is an easy system to learn and maintain and the reps with the company are helpful. We implemented use of this device about 4-5 years ago. We used to use a very old Baxter system which was even more labor intensive and time consuming.
The PRISMA system tells you when you have a problem, what the problem is, and exactly what to do about it, step by step. We don't have nearly the clotting problems as we did with the Baxter system.
Our HD RN's come to set up the equipment and initiate treatment (and change tubing q 72/hrs and prn). The beside RN manages it from there. It's all computerized and very easy to manage. These patients are always 1:1.
Our RN's must be CVVH certified to take a patient requiring CVVH. Certification is accomplished with classses held by either the PRISMA reps or by our unit's CNS. The classes are held a couple times/year. We renew certification once/yr with a written test and demonstration of skills.
We frequently have patients on CVVH, sometimes many patients at once. But then again we are one of those large CTICU's that take the sickest of the sick to begin with.