Use of High-Flow Continuous Renal Replacement Therapy with Citrate Anticoagulation to Control Intracranial Pressure by Maintaining Hypernatremia in a Patient with Acute Brain Injury and Renal Failure

Clin Med Res. 2015 Jun;13(2):89-93. doi: 10.3121/cmr.2014.1238. Epub 2014 Dec 8.

Abstract

Traumatic brain injury and intracranial hypertension often require treatment to optimize patient outcome. There are a variety of complex medical conditions that can preclude standard approaches to the treatment of intracranial hypertension. We describe a case where a novel approach using continuous dialysis with trisodium citrate was used to optimize the outcome of a young male with acute renal failure and acute respiratory distress syndrome in the setting of acute traumatic brain injury.

Keywords: CRRT; CVVH; Dialysis; Intracranial pressure; Renal failure.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / complications
  • Acute Kidney Injury / therapy*
  • Adolescent
  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use*
  • Brain Injuries / complications
  • Brain Injuries / therapy*
  • Citrates / pharmacology
  • Citrates / therapeutic use*
  • Combined Modality Therapy
  • Humans
  • Hypernatremia / chemically induced*
  • Intracranial Pressure*
  • Male
  • Renal Replacement Therapy / methods*
  • Respiratory Distress Syndrome / complications
  • Respiratory Distress Syndrome / therapy

Substances

  • Anticoagulants
  • Citrates
  • trisodium citrate