What is CRRT? - CRRT Explained!

[@ICUAdvantage]

🎓‼ Earn CE Credits! Pre-order ICU Advantage Academy: 👉🏼 adv.icu/academy 💲 10% off Critical Care Academy (CCRN Review): 👉🏼adv.icu/cca (USE CODE "icuadv10") 💲 10% off EACH Month @ Nurisng Mastery membership: 👉🏼 adv.icu/mastery 📝 NOTES available to members! ► KZbin: adv.icu/ym | ► Patreon: adv.icu/pm

[@soumitradas2440]

I have joined to get the notes. But i am not able to see. kindly guide me

[@danny-vp5ct]

This man is a national treasure, so thorough and helpful.

[@ICUAdvantage]

Haha thanks Danny!

[@yacque717]

I really like the way you explain your lessons, plus it's animated so it's easier to understand. Your voice also is soothing and calm. Thank you for all the learnings! Keep going!

[@courtneyharris1915]

Really enjoying your videos. I had a CRRT patient the other day and it was the first time in 6 months, and thats only after learning CRRT at the beginning of the year. I'm able to go through the motions, but I wasn't understanding all the pieces. I've only watched the first two videos of the series, but already feel so much more informed. Thank you for putting the time in and making these awesome videos.

[@sheboxer61]

You just opened my eyes to how this works. The person that taught me make is so difficult and I was not really getting it till nows. Thanks so much for doing this lessons.

[@ICUAdvantage]

So glad to hear that this video helped to put it all together Shirlee! Thats my hope and goal with doing these.

[@kathyk6536]

EXCELLENT..I am a ICURN ..actually attending a 6hour class tomorrow.needed a overview first...thanks ,Kathy RN BSN

[@ICUAdvantage]

Thanks Kathy. Glad you liked it and hope the class went well.

[@heidicampbell4560]

Thank you for this very informative video. As a critical care nurse (of 14 yrs) CRRT is new to our ICU . We had 2 days of training and most recently I was able to apply my new knowledge on 2 patients back to back receiving CRRT in our ICU. This video really helps to explain the process very clearly. Thank you !

[@ICUAdvantage]

Very happy to hear this was helpful for you Heidi! What brought about the change to CRRT finally?

[@yamsonthepan]

I'm crying. Thank you so much for your generosity and patience and kindness to share this with us! :')

[@chrisdaykin3899]

As a Biomedical Engineering Technician - this content is fantastic

[@dagobah1974]

Hi. I am a new ICU RN, and a few days ago I started to use this machine. Thank you so much to make these videos. It helps me a lot to understand what I am doing.

[@ICUAdvantage]

This is great to hear Felix! Happy to hear that is was helpful for you!

[@tammyclark1207]

You did an AWESOME job. I am returning to the ICU after an 8-year absence. This will help me get back on track immediately. THANK YOU.

[@munganiayvonne3548]

You are the best teacher, after two months of internships I did not understand anything... But now I have an idea... Asante Sana mwalimu 🇰🇪🇰🇪🙏🙏❤️

[@ICUAdvantage]

Woohoo!! Happy to hear this and glad to be able to help.

[@trishannajones5947]

Thank you so much. I'm a newer RN but am not CC. It really helped me understand this so I can inform my family how it works

[@troywharton6238]

This was great. My mom is currently in ICU, and instead of using this method to help my mom, the Dr gave her regular dialysis, and it was too aggressive. That method they chose caused her to have heart failure, which caused some brain damage. They didn't even mention CRRT nor SLED, they just did what they wanted to do. Hurtful.

[@JoannC830]

Not all hospital are trained or can offer it. It is beneficial for many pts

[@Zka-ic2hh]

Are you in the U.S.A?

[@Jkimmm]

I'm a nurse that took a hiatus and going through all your videos as a refresher. I wish I had you when I was in nursing school! Thank you so much for your videos

[@ICUAdvantage]

Welcome back! Glad to hear the videos have been helpful for you in your transition back.

[@kunalroy4010]

Thank you. Ive never really worked with a CRRT independently yet this was uber easy to understand. God bless.

[@ICUAdvantage]

Awesome! Really glad to hear that! This is one of my favorite series :)

[@karenmartinez9596]

Thank you for these videos, at first I was like. ooop 4 vids?! but knowing your videos its all worth it once you put it all together and it feels less overwhelming. I recently oriented to a CRRT patient and I kept documents the access, filter, affluent and return pressure but was never told what they meant-UNTIL NOW!! makes so much sense.

[@ICUAdvantage]

Haha thanks Karen! Yeah I truly try to break down the topics into bite sized pieces and especially with complex topics like this, I like the break them up over several lessons and have them build on one another. Its funny, because I don't go into it thinking I'll do X number of videos. I just start going and as I realize its A LOT of info, I start to break it down. I mean, as an example, I managed to make Arterial Lines go on for 6 lessons........ haha

[@matthewresignolo3568]

Just wanted to say thank you for these videos and your knowledge. Such a treat to have these available for free on youtube.

[@ICUAdvantage]

Thanks Matthew. It really is amazing what is out there with this platform these days!

[@malorigalleher1094]

Thank you so much for you videos! You are gifted at being able to break down critical topics into comprehendible videos. I am in my last semester of nursing school and just landed my first job in burn and trauma SICU! Your videos are helping me prepare me for what is coming my way!

[@ICUAdvantage]

How exciting Malori! Congrats on the new job, thats amazing. And thank you for taking the time to leave me a comment. I really appreciate the kind words and so glad to hear that I was able to explain this stuff in ways that are understandable!

[@lobarita]

Studying CRRT so I can take care of sicker patients. Thanks Dr. Watson.

[@ICUAdvantage]

Nice. They def tend to be sicker for sure. And no Dr!

[@amandamoore2868]

Thank you so much for this! I showed these videos to my orientee instead of the ones our hospital had. This was far easier to follow, it even enchanced my understanding as well!

[@WiamKhader]

Great Series, helped me alot on the beginning of my ICU Rotation

[@Noname-rp5fo]

This series is so much better than what they do during preceptorship at my facility. My exposure before having to take a CRRT patient was writing down numbers for someone during half a shift.

[@ICUAdvantage]

Wow, thank you so much Tasha! That's really unfortunate about your introduction to CRRT. We certainly deserve more, especially considering the complexity of these patients.

[@chavonnejohnson3655]

Thank you so much. I just started working as a CICU and I'm so grateful for your videos. As a new grad the ICU can be intimidating, but you are helping to make this transition less daunting. Thanks again! :)

[@ICUAdvantage]

This is great Chavonne! It is a LOT, especially as a new grad. One day at a time. Glad I could help along the way.

[@barbaracherrington375]

I totally understood this part thanks to you. I want to move on to understanding the entire process so I'll check out your other videos on the topic. Thanks

[@chase.trevino03]

About to go into an orientation shift taking a CRRT patient. These videos really help me break down the components and prepare well!

[@lewisha20e]

new learner on CRRT finds this is easy to understand 🙌🙌

[@kellymullen4927]

Thank you for making such a great, user friendly video converting CRRT. This video was very useful when researching the therapies my family member is going through s/p open heart surgery. Thank you again for your knowledge and excellent content!

[@ICUAdvantage]

Hoping for a speedy recovery for your family member and glad you enjoyed the video.

[@apriljones1329]

As a dialysis nurse at a level 1 trauma center this is perfect!!

[@ICUAdvantage]

Thanks April!

[@kyleschrag8166]

I worked at a facility that ran SLED for 24hrs at a time. We didn’t have enough CRRt machines in Phoenix during covid!

[@heatran123]

Just started working in a cviuc and being able to atleast familiarize myself with processes prior to learning them with my preceptor is fantastic. Thank you!

[@queenb23r]

Thanks for your videos Eddie! I’m currently in a very small town ICU, but I’ll be moving to the city and starting in a large teaching CVICU later this month. Your videos have been a helpful foundation for new devices & hemodynamics.

[@ICUAdvantage]

Congrats on the new job! How exciting! Its going to be a bit different, as I'm sure you are aware, but it'll be such a great journey. So glad my videos can help you along that journey! 😊

[@DeniseRene407]

Great video. I am a new grad in the ED. I was taking care of an ICU patient the other day (we didn’t have any ICU beds so we were holding the patient in the ED) and the nephrologist ordered CRRT, which I’d never heard of. The patient ended up getting stat dialysis because his K+ was way off (I’m assuming it was elevated but I don’t remember) and he was hypotensive, so I had to start a levophed drip. It was cool to see the dialysis nurse come in and do the dialysis treatment. It also made me want to learn more about dialysis and CRRT. Thank you!

[@ICUAdvantage]

Really glad you liked it Denise! I always loved a good CRRT patient. Usually very sick and complex. For very high K we often will try to dialize that is it’s much quicker but if unable we can also use dialysate on CRRT that is 2K to drive the potassium down quicker.

[@poljakovaandrea2223]

WHATs the difference between solut and waste product?

[@anayathegoddess3251]

I am a certified HD/CTICU RN. This was VERY VERY well explained. 👏

[@ICUAdvantage]

So awesome to hear! Thank you Anaya!! :)

[@Zka-ic2hh]

Does CRRT decrease the heart frequency of patients during session?

[@Anaya-ez2ri]

​@@Zka-ic2hh heart frequency? I'm not sure what you mean

[@Zka-ic2hh]

@@Anaya-ez2ri Heart rate, pulse. Range 100/60.

[@Zka-ic2hh]

@@Anaya-ez2ri ?

[@manuelito591]

Hey Eddie, just pulled a temporary HD cath on a pt we had on CRRT for about a week. I did a little playing with the HD cath, as any good icu nurse would do 😅 and found that this cath didn’t have a distal and proximal port, but slit ports on different sides of the lumen at the same depth. I had a Doc question me in this recently so it was nice to see that I was right, that the ports were not at different depths on the cath. Just thought I’d share in case someone else was confused about what they are seeing. Thanks for your videos! Love em!

[@ICUAdvantage]

Hey Juan, thanks for sharing! So I did some digging myself and apparently there are 3 main types of HD lines. The split line, staggered, and squared (as you described). There seems to be much debate about what is best out there!

[@danao1796]

Thank you! I'm learning so much from you. I tell everyone about your channel! 🌼😊

[@ICUAdvantage]

So awesome! So glad to hear this from you Dana! And thank you so much for passing along the word. I hope these videos can help as many people as possible.

[@angie5624]

I have to saw this was super helpful cause i had some things messed up in my mind and this video really helped me clear them out. Thank you for making this video.

[@ICUAdvantage]

This is awesome to hear. This is why I make these videos. Hopefully some video will help someone to make something click or make more sense. Thank you for taking the time to leave a comment!

[@parisazamani1751]

I haven’t been qualified to take CRRT course yet as I am a new ICU nurse. I have always been wondering how it works. I’m looking forward to the next lessons. Thanks a lot as always. 👍

[@ICUAdvantage]

More than glad to help and happy to hear you liked the video. Its always good to learn about things that are new, especially in the ICU. Best wishes on your new journey in critical care!

[@tse10sherpa59]

Very nice explanation. Thank you ❤

[@vivienpaquia5242]

Fantastic basic lesson on CRRT ! Thank you. Also do you sell any DVDs?

[@lizl.ajpacaja2017]

Thank you for clear explanations! Super helpful!

[@drenette1]

Thanks for explaining the CRRT! You are a great teacher!

[@ICUAdvantage]

Thanks for that Lee. Glad you enjoyed it

[@UndeadKing6th]

Amazing video. Drawings were so detailed, clear, and easy to follow

[@ICUAdvantage]

Thank you so much Gabriel!

[@ramawadhsinghkushwaha720]

I found these excellent vides which are really helping me to understand the complex session in very much simplified way. Thanks to the expert. I am from India-Dr R A S Kushwaha MD

[@ICUAdvantage]

Thank you so much! Glad you are liking the videos and that they are proving helpful for you. Thanks for taking the time to leave a comment.

[@jentlejd]

This is a great video about CRRT. I'm going to share it with our new nurses about to start learning. Thank you for posting this.

[@ICUAdvantage]

Awesome! Thank you so much for sharing along and I hope others find it useful!

[@The26thPodcast]

New icu nurse, thanks for sharing very helpful.

[@ICUAdvantage]

Welcome to the world of critical care nursing Victoria! Glad you liked the video!

[@Andy99933]

Great video. You can have a positive access pressure, if it is connected to a ecmo circuit.

[@ICUAdvantage]

Interesting. Makes sense. We don't run our CRRT in our ECMO circuit. They used to years ago before I did ECMO. Does the positive access pressure not throw off the machine from running properly?

[@Andy99933]

It will alarm initially, but it is the soft alarm you can bypass. We don’t do it on every ecmo, but it is easier to add to the circuit rather than placing a line. On the downside, it seems more dangerous, especially on VA ecmo.

[@ICUAdvantage]

@@Andy99933 Good to know! I believe they stopped running it through the circuit due to some serious incidents that occurred and therefore we just always use an HD line.

[@ZiMakeUp]

Eddie, if you have time...could you do common occurrences and normal values using the prismaflex such as if the filter pressure is 400+ or tmp pressure is 200+ or if return pressure is negative and what to do? Not sure if that makes ends.

[@ICUAdvantage]

The last lesson in the series is covering a lot of pearls. I think I have some of that info in there. I may do a more "troubleshooting" video too.

[@ZiMakeUp]

ICU Advantage yes please to all!!!

[@pillowcase7420]

Thank you! I am currently doing my filter pack and your videos helped me a lot!

[@ICUAdvantage]

Awesome! Glad to be able to help!

[@edenjoy1861]

Very useful video 😊 thanks for sharing!

[@ICUAdvantage]

My pleasure 😊

[@linhlanbui4946]

Love to listen to your lesson! Very clear explanation! Thank you very much!

[@ICUAdvantage]

Appreciate that! Happy to hear they are helpful.

[@simmer07]

Amazing work. Thank you so much. Help understand what's happening with my friend.

[@ICUAdvantage]

I'm so sorry to hear about your friend and hoping for a speedy recovery for them! Take care.

[@simmer07]

@@ICUAdvantage You're so kind-hearted, thank you. We will fight on

[@magdakolasa8555]

This was beyond excellent, thank-you!

[@Laringoskop]

Thank you very much, you explain all this stuff so simple, please continue, I can't wait to see the next chapter of this video.

[@ICUAdvantage]

So glad to hear this! Thank you and happy that you enjoyed it.

[@karinlarsson3846]

I love this !! its very helpful😊😊

[@zdo3]

Excellent video, Eddie! I'm in nursing school and this, along with many of your other videos, has been incredibly beneficial!

[@ICUAdvantage]

Thats so awesome! So glad these videos have been such a help to you. Best of luck finishing out nursing school and beginning your nursing journey!

[@zeezeebo]

You’re the best! Period!

[@ICUAdvantage]

I really appreciate that! 😊

[@louluminar]

Eddie, could you please explain what are the instances when the Effluent pressure becomes "positive"? Great lecture btw 👍

[@ICUAdvantage]

Great question Louis! So I wish I had an exact answer but my best guess is in the situations where we are pulling off little to no fluid or actually running them positive and some of the natural forces to move water across the membrane (such as osmotic pressure) lead the machine to detect more fluid moving across than we should be so it then exerts some positive pressure the resist this water movement. Again, wish I had a better answer for you, but this seems to make sense to me. Again this isn't all that common but I have seen it multiple times before.

[@BarbaraBoamah]

Thanks for all you do! ✅✅

[@ICUAdvantage]

You're welcome. Truly my pleasure!

[@rma3899]

Again. Thank you for the amazing job.I believe for the filter position it can be concurrent to counter -current . Not necassiraily blood flow from bottom

[@ICUAdvantage]

Interesting! I haven't seen concurrent flow, but I certainly haven't seen it all. Thanks for sharing!

[@laurenplath6100]

This was a great refresher! Really diggin this series! Thank you for taking the time!

[@ICUAdvantage]

Sweet!! I'm glad you are liking it. I may be a little partial, but I think the series is great! :)

[@annnguyen504]

Can you please explain how to calculate patient fluid removal rate for next hour?

[@Goncalofc]

Very good lesson! Looking forward to watching the following ones. Thanks a lot!

[@ICUAdvantage]

Glad to hear you liked it and I hope you enjoyed the others as well!

[@moila04]

Your videos are so easy to understand, I love them, thank you!☺️

[@ICUAdvantage]

Happy to hear this! Thank you Mia and glad you enjoy them

[@sheboxer61]

This lesson was amazing!!! Can't wait for the next one.

[@ICUAdvantage]

A few more good ones coming in this series 😊

[@Zka-ic2hh]

Does CRRT decrease heart rate during a session? How much? Time frame?

[@loganschannel7294]

Thanks for the video....i like your presentation ...it makes me easier to understand the stuff in ICU....perhaps you can gv more detail in explaination of the procedures in ICU and basic physiology behind it and in depth so that newbie like me can learn better.

[@ICUAdvantage]

Thank you!

[@dorothyotogbolu6485]

How can i like these videos more than once?

[@delsonpaul6553]

Very helpful explanation... Thanks

[@ICUAdvantage]

Great to hear!

[@KrisMiss97]

Thank you for these videos Eddie! I just started my externship on PICU and find these videos so helpful. Can't wait to go through the rest of them :)

[@ICUAdvantage]

How exciting Kristie! Congrats on the externship. So cool! So glad that you liked the video and I hope you enjoy the rest. Best of luck on your externship!

[@Xxaldos007xX]

Thanks for the explanation!

[@ICUAdvantage]

Truly my pleasure!

[@sourabhjain2245]

Thanks Eddie . U r doing amazing work. 👍❤️

[@ICUAdvantage]

Wow, thank you so much. I appreciate that!

[@sunenaanas4811]

This was a life saving therapy for my husband. He came back to life only bcz of this dialysis

[@ICUAdvantage]

Thanks for sharing and glad he was able to get what he needed!

[@nirmaliemadurawala6042]

Excellent explanation, thanks 😊

[@ICUAdvantage]

Really appreciate that!

[@wasimshehzad6377]

Tremendous work dear I am master trainer for crrt in icu patients. I think need to work on some troubleshooting during treatment

[@ICUAdvantage]

Thanks so much!

[@hambatu2970]

Hi Eddie, your channel is truly the best. I hope you read this comment and answer my question. I have years of experience dealing with crrt. but this is one of the things i don't fully understood. The fluid replacement(purple), we can set in the machine as pre or post dilution right? my confusion came between with this replacement fluid and the PBP fluid(white). what is each significance and difference between them? If the nephrologist order a pre dilution 1000 ml/hr, can we used both of the pumps or one is enough? like we set only PBP 1000 ml/hr and set the purple zero or just purple fluid set at 1000 ml/hr in pre dilution?

[@fencer5411]

Fantastic lecture. Keep up the good work!

[@ICUAdvantage]

Thank you so much!

[@PregoGB135]

Thanks! Explained clearly!

[@terimessiha3498]

Very clearly presented, and easy to understand.

[@ICUAdvantage]

So great to hear this! Thank you!

[@mirandaalexis]

Even as an ER nurse, I still like knowing how this works

[@ICUAdvantage]

It is pretty cool stuff! 😊

[@lindiweK1964]

Well presented

[@minhthanhtran1015]

I want to have transcript of this video. thank you so much.

[@ICUAdvantage]

I do have the notes for all lessons available to the KZbin and Patreon members

[@marygracediannecaingcoy983]

Been waiting for this. Yehey!!! Next with the mode please. Thank you.

[@ICUAdvantage]

Yay!! Next lesson is on the principals and then after that is the modes 😊

[@jawharahalr4563]

Thank you so much this channel is helpful 💛

[@ICUAdvantage]

So happy to hear this!

[@MC-df3sk]

Is effluent pressure the same as transmembrane pressure?

[@lushavhanamashamba2716]

Great explanation👌👌👌

[@ICUAdvantage]

Thank you 😃

[@allyu274]

Question…for someone getting CRRT and receiving blood products or a fluid bolus, should PFR be decreased to 0? My thought process is that it’ll just get dialyzed out unless size of protein, molecule, etc matters? Idk 😅

[@ICUAdvantage]

Good question and I talk about this in the last video of this series, but if giving volume or blood for hypotension, then no we typically do not want to remove the volume via CRRT as we are then working against ourselves.

[@sckwan]

Excellent session. Thanks.

[@ICUAdvantage]

Very welcome. Glad you enjoyed it.

[@etlay5684]

Thank you Eddie for a great lesson. When having problems with the access pressure (too negative) we were told to swap the access to the blue and return to the red, will that result in poor clearance of toxins as you mentioned that the catheter tip has proximal and distal ends? Thanks

[@ICUAdvantage]

It depends on the type of catheter you use and how it manages flow of those lumens, but potentially yes.

[@miriamc.s.3516]

Critical care NP student here...THANK YOU!!

[@ICUAdvantage]

Awesome! Welcome!

[@ShirleyVanDerLinde]

Thanks so clearly explained

[@ICUAdvantage]

Glad to hear it!

[@waqasahmad4245]

Oh wao. Absolutely clear and precise.

[@ICUAdvantage]

Thank you! Glad you liked it!

[@DavidTiptonJr]

I love this video series! I'll be a new grad going straight to ICU soon, and I'm trying to take it alllll in now. Wouldn't the oxygen saturation after the filtration actually be higher than before? You spoke to the colors of red and blue not being symbolic of the oxygen saturation, and that question came to mind. Since the blood leaves the filter with less hydrogen ions, we'd see a left shift in an oxygen dissociation curve, right?

[@ICUAdvantage]

Hey David, glad to hear you liked the video! So, while you are technically correct with the disassociation curve, the physiological effects of that are more than likely going to be non-existent. As soon as the blood returns to circulation its going to have no real measurable effect on the patients saturation. Sure over time, balancing of pH could improve our curve. I don't know if you checked a VBG pre and post filter if you'd see any different in svo2 or not, but I can say no one is checking that. Remember, we are talking venous blood being pulled and venous blood being returned back to a vein. Our focus here is on filtration of solutes. Try not to over complicate things for yourself :) Now, your understanding of the disassociation curve is important and good that you are thinking about that. It just isn't applicable here is all. Don't forget about it and always be thinking of it. A lot of people don't understand it or give it any second thought.

[@ramandeepkaurghotra5933]

hey i am asking question out of the topic, could you please tell me what is PRISMA . used by icu clinical leaders

[@Zeeman999]

Awesome video!!

[@tyfike]

So good. Well done. Thank you, Thank you, Thank you

[@ICUAdvantage]

You are very welcome Ty! Really glad that you liked it!

[@dansaxe]

Can CRRT and ECMO be used concurrently? Do they need separate access, or can the CRRT be connected to the venous line of the ECMO? Thanks for the continued great content.

[@ICUAdvantage]

Great question. Absolutely they can be used together, and many times are. Where I work, we always do a separate HD line for CRRT, but you can also run in as a part of the ECMO circuit. They used to do that at my facility years ago, but there was an incident, so they stopped.

[@SamanthaJones-wg3ty]

Excellent!!❤

[@ICUAdvantage]

Thank you! 😃

[@chillnotb]

So good! Very interesting content) from Russia with great respect!)))