CRRT Management Note (Pediatrics)

Date/Time: [date and time of note entry]

Patient Weight: [weight in kg] ([date measured])

Location: [care location/bed]

CRRT Day: [number]

Filter/Circuit Age: [hours since placed] ([timestamp of placement])

Status Summary

[Single-sentence summary capturing: CRRT day number, active indication(s), modality [SCUF / CVVH / CVVHD / CVVHDF], anticoagulation strategy [regional citrate / heparin / none], net UF goal [mL/kg/hr], and hemodynamic status [stable / requiring support]].

Interval Events

[Brief narrative of the past 24 hours including total downtime and reasons, whether circuit changes were scheduled or unscheduled, hemodynamic tolerance of therapy, and any bleeding or clotting events]. (If no significant events, write: "No significant interruptions or events.")

CRRT Parameters

Prescription (current orders)

• Modality: [SCUF / CVVH / CVVHD / CVVHDF]
• Blood flow (Qb): [mL/min] ([mL/kg/min])
• Dialysate flow (Qd): [mL/hr] (enter "not ordered" if not used)
• Replacement flow (Qr): [mL/hr total] ([pre-filter % / post-filter %]) (enter "not ordered" if not used)
• Net UF target: [mL/hr] ([mL/kg/hr])
• Effluent dose target: [mL/kg/hr] ([rationale: standard AKI / augmented clearance])

(Enter "not available" if any prescribed parameter is unavailable. Do not infer values.)

Delivered (last 24h)

• Delivered effluent dose (average): [mL/kg/hr] ([% of prescribed achieved])
• Net fluid removal achieved vs goal: [achieved] vs [goal]

(If delivered data unavailable, state reason and plan to obtain. Never estimate delivered dose from prescription.)

Anticoagulation

Strategy: [regional citrate / heparin / none]

If regional citrate: Citrate rate [value]; calcium replacement rate [value]; post-filter iCa [value] (target per protocol); systemic iCa [value] (target per protocol); citrate accumulation concern [yes/no with rationale if yes].

If heparin: Infusion rate [value]; monitoring [aPTT / anti-Xa / ACT] with target [range]; bleeding risk [low / moderate / high]; platelet/HIT status [if relevant].

If none: Reason [bleeding risk / other]; mitigation [pre-dilution strategy, expected shorter circuit life].

(Include only the section corresponding to the active anticoagulation strategy.)

Circuit/Access Status

Circuit: [running without issues / intermittent downtime / currently down]

Pressures: Access [value], Return [value], TMP [value] — [stable / trending up / concerning]

Access: [adequate flows / positional issues / frequent alarms]

(If no issues: "Circuit running without alarms; pressures stable.")

Labs Reviewed

Electrolytes: Na [value], K [value], Phos [value], Mg [value], Ca [value] — [interpretation]

BUN/Cr: [values] — [trend]

Acid-base: [pH, pCO2, HCO3, AG] — [interpretation]

Anticoagulation labs: [iCa if RCA; coags if heparin] — [interpretation vs target]

Other pertinent labs: [lactate, ammonia, drug levels as relevant]

Pending: [critical labs pending and expected timing]

(Do not copy forward old values. Include only today's verified results.)

Assessment and Plan

(Problem-oriented; address each applicable area with specific actions. Omit if not applicable today.)

Clearance: [modality adequacy], [dose target], [prescribed-vs-delivered gap], [plan to optimize].

Fluid/UF: Net UF goal next 24h: [mL/hr and mL/kg/hr]. Guardrails: [hemodynamic thresholds to reduce UF or hold; notify criteria].

Anticoagulation: [strategy and targets], [monitoring frequency], [criteria to adjust], [notify if concerns].

Electrolytes: [replacement plans], [dialysate adjustments], [medication dosing considerations for high-clearance therapy].

Access/Circuit: [status], [planned interventions: continue / filter change timing / line evaluation].

Weaning: [criteria for trial off CRRT or transition plan]. (Include only if clinically relevant today.)

Communication: Orders [updated / no changes]; team notified of UF guardrails; notify if [key thresholds and concerns].