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

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.

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.

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).

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.