What's "CVVH" in the ICU?? - page 2

:uhoh3: Can someone please help me out? I am a final-semester nursing student starting ICU tomorrow - I have a patient on "CVVH", and though I have many fine medical books, a big PDA, and lots of... Read More

  1. by   withasmilelpn
    I'm fascinated, let us know what happens, please.
  2. by   cardiacRN2006
    Wow! Cool patient!
  3. by   tutored
    I will definitely let you know! Appreciate the care.
  4. by   BBFRN
    Poor guy- I hope he makes it through his surgery, Tutored. His poor family must be terrified. Does he have kids?

    Hugs to you. I know it must be hard dealing with being fascinated, yet feeling terrible for this patient at the same time. Let us know how he does.
  5. by   caroladybelle
    In ICU hemo/onco units, we have these, usually secondary to very severe Tumor Lysis Syndrome.

    Needless ta say, they are sick as all get out.
  6. by   richardjboro1
    So is this sort of the same type of care for a bypass machine? 2 on 1 with someone running the vent and someone doing patient care? Sounds extremely interesting/very sad though.

    Richard
  7. by   time4meRN
    look under hemo dyal. or prisma
  8. by   tutored
    Quote from richardjboro1
    So is this sort of the same type of care for a bypass machine? 2 on 1 with someone running the vent and someone doing patient care? Sounds extremely interesting/very sad though.

    Richard
    Richard, that was, indeed, the setup...The primary RN constantly tweaked and adjusted the CVVH machine to the MD's desired net intake, or outtake...(In this case, the md wanted a deficit - lots of peripheral edema and anasarca due to the whopping sepsis in this patient's body - how about five antibiotics, plus fluconazole, plus steroids, and full sedation including paralysis? The amazing thing is this person's liver is actually holding up!) Thanks for asking.
  9. by   tutored
    Quote from Baptized_By_Fire
    Poor guy- I hope he makes it through his surgery, Tutored. His poor family must be terrified. Does he have kids?

    Hugs to you. I know it must be hard dealing with being fascinated, yet feeling terrible for this patient at the same time. Let us know how he does.
    Thanks for asking, and giving me the necessary reminder as a student that there's a person under all that tubing! He is in his mid-sixties, with visiting children and a bewildered wife. Tons of bible reading...he's full code, and there's nothing but optimism,...a kind of optimism that really isn't realistic in this case. As I said before, he was going into the OR this afternoon to have some partial-closure of his 13-inch abdominal incision...the only thing he's got going for him is his liver is somehow managing eighteen different meds (including steroids) without his enzymes elevating. I'll let you know! You're nice to ask.
  10. by   palkie
    most nurses in our hospital still call this cvvhd - continuous veno-venous hemodialysis, because that is what the older machines were called. depending on where you work and the speed at which they upgrade their technology, you may actually be using crrt. our hospital uses machines made by prisma, and it stands for continious renal replacement therapy.

    it is the same thing - an "artificial" kidney that takes over for patients in renal failure. it causes less major swings in patient acuity due to the 'continuous' factor than intermittent hemodialysis and is very good for icu patients.

    yes, it is possible, even likely that your patient may be sick, even very sick - but it is possible they may be relatively stable. i have used these machines (even the old honking dinosaurs) for over 14 years. patients on these newer machines do much better than in the past.

    we have also had patients on them who really were really very stable, although at our facility we try our best to make these 1:1 nurse/patient ratio assignments whenever possible.

    it takes a while to get the hang of writing down all the numbers every hour, and can get busy if your line (access) is not patent, but certainly you will have help - a preceptor or someone who can show you the ropes, right?

    ask all the questions you can. there are no stupid questions! and anyone who says otherwise is an idiot, so stay away from them!! (haha!) much more stupid not to ask! and yes, unfortunately some nurses do eat the young, so beware - but keep asking, and you will find someone who will help you and guide you. we're not all bad! good luck!
  11. by   Christie RN2006
    Sounds like a patient that we had recently in the ICU where I work. This one particular patient just about coded several times... I never did hear what happened.

    What you mentioned about remembering that there is a patient under all the tubing is very true. As a new nurse, sometimes it is very hard to see past the tubing to the patient. You are so focused on the patients physical needs and getting everything right that you tend to look past the patient emotional needs and their family. It is something that comes with time. I have only been a nurse for a little over a year now and I am starting to get better at it One thing I learned early on is that the family is sometimes just as needy as the patient is. You need to not only provide support for your patient, but their family too. The family will then in turn support the patient. Unfortunately it doesn't always happen that way though.
  12. by   Diary/Dairy
    Quote from tutored
    Yeah, I can, thanks to everyone else for telling me what it is! It's a continuous filtration of the venous blood, through a large vein (my patient's tap is near the subclavian), mainly for patients who can't handle any insults to their hemodynamic stability and therefore aren't candidates for dialysis. My patient is septic on top of everything else wrong (mechanical ventilator, peritonitis with abdominal abscess, heart failure, acute renal failure), so the last thing he needs would be "another" opening into the body! It sure seems like he's toast. Add IV fentanyl, versed, and a muscle relaxant, TOGETHER!!! He's been in for 3-1/2 weeks. I was scared earlier today to start caring for him, but the pep talk from everyone has me excited to learn. Thanks again, everyone!
    Sounds like one fun patient to me - I LOVE the sickies when I can just focus on them - I am working tele now and I miss my vents/balloon pumps/CVVH all that good stuff!!
  13. by   cmo421
    Quote from tutored
    If any of the four kind RNs who responded to my plea for help and info yesterday - thanks again! Today went well, though I felt a lump in my throat when I first went in and saw the CVVH machine with a huge double-lumen line coming out of the subclavian, plus two picc lines, each triple lumen with SEVEN concurrent IV drips, foley draining the worst-colored urine I've ever seen, mechanical ventilation, septic beyond belief, and for flavor, a COMPLETELY OPEN abdominal cavity, with a incision from xiphoid to pelvis, covered only with what looked like a sheet of plastic wrap over it (waiting for preliminary closure in the OR), with four JP drains in various areas. You were all right - he was truly a sick man - I'm assigned to him tomorrow, but I'm afraid he won't survive the OR this afternoon. Thanks again, all of you!:spin:


    my kind of pt, I am jealous,,,,lol . You will learn lots from this one.

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