Continuous Veno-Venous Filtration

Nikki Reynolds and Julie Armstrong have produed the following documents to guide staff in setting up and prescribing CVVH.

Guide to blood flow rates and substitution rates

Haemofiltration Guidelines

Prescription sheet

Please use the sheet below to prescribe haemofiltration.

Prescription for CVVH

Drug doses in CVVH

Although there is guidance in the BNF-C on adjusting drug doses for different degrees of renal impairment there is no standard reference source to find accurate dose adjustments for drugs when patients are on CVVH. The following information is based on work in adults and the principals applied to children bearing in mind that it is important to consider the risk of preserving renal function at the expense of the child surviving.

Drug	Route	Recommended dose on CVVH
Aciclovir	IV	Use 100% of normal dose every 12 hours
Amiodarone	IV/PO	Dose as normal renal function
Amoxicillin	IV	Dose as normal renal function
Ambisome	IV	Dose as normal renal function
Atracrium	IV	Dose as normal renal function
Benzylpenicillin	IV	Dose as normal renal function
Cefotaxime	IV	Dose as normal renal function
Ceftazidime	IV	> 1 month :100% of normal dose every 12 hours
Chloral hydrate	Po/PR	Start with 25mg/Kg and increase if needed
Ciprofloxacin	IV	Dose as normal renal function
Clarithromycin	Po/IV	Dose as normal renal function
Clindamycin	IV/PO	Dose as normal renal function
Clonidine	IV/PO	Dose as normal renal function
Co-amoxiclav	IV	100% dose every 12 hourly
Co-trimoxazole	IV	Normal dose & frequency for 3 days then reduce dose to 50%
Erythromycin	IV/Po	Dose as normal renal function
Flucloxacillin	IV/Po	Dose as normal renal function
Fluconazole	IV	Dose as normal renal function
Furosemide	IV	Dose as normal renal function (NB bigger doses may be needed)
Gentamicin	IV	<1 month. Give 4mg/Kg and check level at 24 hours. >1 month < 12 years. Give 5mg/Kg & check levels at 18 – 24 hours >12 years. Give 5mg/Kg & check levels at 18 – 24 hours NB always wait before levels are back before giving next dose
Hydrocortisone	IV	Dose as normal renal function
Linezolid	IV	Dose as normal renal function
Meropenem	IV	Use normal dose & frequency but do not exceed 20mg/Kg/dose if less than 50Kg or 1g 8 hourly if over 50Kg.
Metronidazole	IV	Dose as normal renal function
Omeprazole	IV/PO	Dose as normal renal function
Ondansetron	IV	Dose as normal renal function
Oseltamivir (Treatment dose)	PO	100% of the normal dose every 24 hours
Oseltamivir (Prophylaxis)	PO	100% of the normal dose every 48 hours
Phenytoin	IV	Dose as normal renal function
Ranitidine	IV	Dose as normal renal function
Rifampicin	IV	Dose as normal renal function
Tazocin	IV	Dose as normal renal function
Vancomycin	IV	All ages. Give 15mg/Kg and check level at 24 hours Do not give dose until level < 10mg/L NB always wait for levels before giving the next dose.
Vecuronium	IV	Dose as normal renal function

Zoe Taylor Dec 2010

Cardiff and Vale uLHB Paediatric Intensive Care Unit

Referrals
02920 745413

External links

Continuous Veno-Venous Filtration

Cardiff and Vale uLHB Paediatric Intensive Care Unit

Referrals 02920 745413

External links

Continuous Veno-Venous Filtration

Referrals
02920 745413