Dialysis in ICU

cCommencement of continuous renal replacement therapy (CRRT) in the ICU is at the discretion of the intensivist on duty.  The first line anticoagulation is citrate anticoagulation, unless there are contraindications.  Other forms of anticoagulation may be considered after taking into account other factors, e.g. liver function, bleeding risk and need for systemic anticoagulation for other reasons. Unless the patient is systemically anticoagulated, or at signifiant bleeding risk, additional VTE prophylaxis anticoagulation is still required.

At Bendigo Health, the methods of anticoagulation are:

1. Regional citrate anticoagulation
2. Unfractionated heparin with no protamine reversal 
3. Unfractionated heparin with protamine reversal 
4. No anticoagulation