Do all your hospitals do CRRT?

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Specializes in acute/critical care.

My hospital does not offer CRRT in any of our ICUs. It isn't that large of a facility (?300 beds) but I thought this was more or less a modern standard of available care. We have traditional dialysis and aquapheresis, but no CRRT.

Do any of your hospitals not do it, and if so, how do you get away with it (other than being too small to do it, and it would be a ship-out sort of a deal?)

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Specializes in Critical Care.

We actually dont do it at my hospital either. Granted our ICU and CCU is a combined 15 beds. We usually just do conventional HD, but when Pts are hemodynamically unstable it makes for a couple of hours of moving drips ever 2 seconds to maintain adequate perfusion to organs and everything else. I think it's ridiculous not to have it because most of the patients in icu wont tolerate losing 2-3 L of fluid in 4 hours.

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Specializes in Nephrology, Cardiology, ER, ICU.

Do you transfer out those pts that need CRRT?

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

The hospital where I work offers it in SICU, MICU and PICU but we are the only hospital in the region that does it. None of the smaller hospitals (100-300 beds) do it. We regularly get patients from the VA system as they don't do it either. I don't know why. I have been over there and they have all the equipment.

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Specializes in acute/critical care.
Do you transfer out those pts that need CRRT?

I have never seen someone shipped out that could benefit from it. The doctors just get around it by doing what they did before CRRT was available -- high dose lasix/bumex gtts and pressors to support B/P if they do try to run them on HD. Often on the HD runs they will opt to not pull any fluid but with that much blood in the circuit, there are usually still hemodynamic problems.

What is with the VA not doing CRRT? Is that true? I haven't heard that before.

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Specializes in CVICU.
I have never seen someone shipped out that could benefit from it. The doctors just get around it by doing what they did before CRRT was available -- high dose lasix/bumex gtts and pressors to support B/P if they do try to run them on HD. Often on the HD runs they will opt to not pull any fluid but with that much blood in the circuit, there are usually still hemodynamic problems.

What is with the VA not doing CRRT? Is that true? I haven't heard that before.

This makes me glad I know something about ICU care so if this stunt ever gets pulled on one of my loved ones I could demand that they be sent somewhere that will not subject them to various forms of organ-killing therapies.

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What is with the VA not doing CRRT? Is that true? I haven't heard that before.

I work at a VA and we definitely do it. I think it must vary by hospital.

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Specializes in MICU/SICU.

The VA I work at does it also.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

What is with the VA not doing CRRT? Is that true? I haven't heard that before.

*** I wasn't trying to make a statement about every VA hospital. I just mean that the VA hospital nearest us send us patients for CRRT from time to time and I know they don't do it. I wasn't trying to make a statement about every VA hospital.

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Specializes in acute/critical care.
*** I wasn't trying to make a statement about every VA hospital. I just mean that the VA hospital nearest us send us patients for CRRT from time to time and I know they don't do it. I wasn't trying to make a statement about every VA hospital.

I wasn't sure if you were or not. I sort of figured that at least some of the VA hospitals must do it since it is a huge nationwide system, but you never know....

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Specializes in MICU/SICU.

I was replying more to opensesame but not to be arguementative so much as to keep the facts straight :)

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Specializes in CVICU/ER.

Yep, ours does.

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