Adequacy of RRT in the Critically Ill: Membrane and Filter related factors
Effective treatment delivery in CRRT can be very different from prescription
Membrane permeability decreases over time reaching critical values after 24 hours of use
Filter clotting occurs in high percentage of cases after the first 24 hours leading to blood loss
High anticoagulant dose is required to maintain filter patency beyond 24 hours
In a randomized trial, 90% of prescription target was achieved by changing the filter every 24 hours
The cost/benefit ratio of changing the filter at 24 hours in CRRT seems to be in favor of this policy