Use of sodium citrate anticoagulation in a pediatric continuous venovenous hemodialysis patient.

CVVHD therapy in critically ill pediatric patients presents many challenges. The ability to maintain hemodynamic stability in the face of multiple fluid and medication requirements made this therapy a successful treatment option. The difficulties often associated with heparin anticoagulation were avoided through the use of citrate, and this was achieved without any bleeding complications. Using a collaborative approach of critical care nurses from one facility and nephrology nurses from another was a unique experience. The patient benefited from the professionals' expert care. All nurses collaborated in meeting jointly set patient goals.