Use of saline flush to prevent filter clotting in continuous renal replacement therapy without anticoagulant.

OBJECTIVE: This study aims to compare filter life between saline flushed and non-saline flushed strategies in critically ill patients at high risk of bleeding who are undergoing CRRT without anticoagulation. MATERIAL AND
METHOD: A cohort of 121 critically ill patients with severe acute kidney injury (AKI) requiring CRRT in the medical intensive care unit (ICU) and cardiac care unit (CCU) of a tertiary care academic center were included. 78 of them used saline flushed through CRRT circuit.
RESULTS: There was no significant difference between the two groups of treated patients in baseline characteristics, including the extent of coagulopathy and platelet count. Mean circuit survival was 21.2 h for circuits using saline flush and 20.4 h for those using non-saline flush (p = 0.8).The Kaplan-Meier curves revealed no difference in circuit survival time between saline flushed and non-saline flushed groups (p = 0.8).
CONCLUSION: The use of saline flush into pre-filter site of CRRT circuit does not provide any benefit on circuit clotting prevention in high-risk of bleeding patients requiring CRRT without anticoagulant.