CRRT question

chare · Oct 19, 2022

3 hours ago, NewNurseinTraining said:

I’m having a hard time understanding the difference of net zero, net even, and net negative.

For Crrt , what's the difference between pulling net negative and net zero ?

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We use the terms net negative, even, or positive to describe the patient's overall fluid balance at 0700. Net negative: output > intake, net even: output = intake, and net positive: output < intake. Our nephrologists order the fluid removal rate as zero when we either start or restart therapy, but I don`t recall ever having heard the term "net zero" being used in any capacity.

3 hours ago, NewNurseinTraining said:

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From my understanding pulling net negative is.. if my intake was 180 then I would want to remove 180. If I don't want to pull zero then I remove nothing.

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If hourly intake and fluid removal were both 180 mL, the overall fluid balance for the hour would be net even, not negative.

3 hours ago, NewNurseinTraining said:

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What if I wanted to pull net negative 200? And my intake is 180? If I remove 200 wouldn't that technically mean I'm removing net negative 20? How would I remove net negative 200?

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You're not removing "net negative 20" you're removing 200 mL, which results in the patient being net negative 20 mL. If the patient's intake is 180 mL and your goal is to be net negative 200 mL you would need to remove 380 mL.

MaxAttack, BSN, RN · Oct 19, 2022

(Total intake) - (total output) = net

Eg.,

(500 cc IV intake) - (600 cc CRRT removal) = net negative 100

(500 cc IV intake) - (100 cc foley output - 400 cc CRRT removal) = net 0 / net even

11 hours ago, chare said:

I don`t recall ever having heard the term "net zero" being used in any capacity.

Maybe a regional thing? Net zero is used instead of net even at the last couple places I've been.