Crrt filters Hf-20 weights based Crrt prescription in poster format
Reading File
Finding Sources
Searching the Web
CRRT HF-20 filter weight based dosing prescription pediatric neonatal 2024
Reading Web Page
https://achpccg.com/wp-content/uploads/2025/05/tms-ach-crrt-…
Finding Sources
Running Command
ls -la /home/daytona/workspace/ 2>/dev/null || echo "workspace empty"
Running Command
mkdir -p /home/daytona/workspace/crrt-poster
Writing File
~/crrt-poster/crrt_hf20_poster.html
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<title>CRRT Prescription Poster – HF-20 Weight-Based</title>
<style>
@import url('https://fonts.googleapis.com/css2?family=Inter:wght@400;600;700;800;900&display=swap');
* { margin: 0; padding: 0; box-sizing: border-box; }
body {
font-family: 'Inter', Arial, sans-serif;
background: #f0f4f8;
display: flex;
justify-content: center;
padding: 20px;
}
.poster {
width: 1122px; /* A3 landscape approx at 96dpi */
background: #ffffff;
border-radius: 12px;
overflow: hidden;
box-shadow: 0 8px 32px rgba(0,0,0,0.18);
}
/* ===== HEADER ===== */
.header {
background: linear-gradient(135deg, #0a3d62 0%, #1a6fa8 60%, #0e8b8b 100%);
color: white;
padding: 28px 40px 22px;
display: flex;
align-items: center;
justify-content: space-between;
}
.header-left h1 {
font-size: 34px;
font-weight: 900;
letter-spacing: 1px;
line-height: 1.15;
}
.header-left h1 span { color: #5fd8e8; }
.header-left p {
font-size: 13.5px;
margin-top: 6px;
opacity: 0.88;
font-weight: 400;
}
.header-badge {
background: rgba(255,255,255,0.12);
border: 2px solid rgba(255,255,255,0.3);
border-radius: 10px;
padding: 10px 22px;
text-align: center;
}
.header-badge .badge-title { font-size: 11px; text-transform: uppercase; letter-spacing: 1.5px; opacity: 0.8; }
.header-badge .badge-main { font-size: 26px; font-weight: 800; color: #5fd8e8; }
.header-badge .badge-sub { font-size: 11.5px; opacity: 0.85; }
/* ===== SECTION LABEL ===== */
.section-label {
font-size: 10.5px;
font-weight: 700;
text-transform: uppercase;
letter-spacing: 1.5px;
color: #0a3d62;
background: #e8f4fd;
border-left: 4px solid #1a6fa8;
padding: 5px 12px;
margin-bottom: 10px;
border-radius: 0 4px 4px 0;
}
/* ===== LAYOUT ===== */
.body {
padding: 22px 32px 26px;
display: grid;
grid-template-columns: 1fr 1fr 1fr;
grid-template-rows: auto auto auto auto;
gap: 18px;
}
.card {
background: #f8fafc;
border-radius: 10px;
border: 1.5px solid #e2eaf3;
padding: 16px 18px 14px;
}
.card-blue { border-top: 4px solid #1a6fa8; }
.card-teal { border-top: 4px solid #0e8b8b; }
.card-orange { border-top: 4px solid #e67e22; }
.card-red { border-top: 4px solid #c0392b; }
.card-green { border-top: 4px solid #27ae60; }
.card-purple { border-top: 4px solid #8e44ad; }
.card-navy { border-top: 4px solid #2c3e50; }
.card h3 {
font-size: 13px;
font-weight: 800;
color: #1a2940;
margin-bottom: 10px;
display: flex;
align-items: center;
gap: 7px;
}
.card h3 .icon { font-size: 16px; }
/* ===== TABLE ===== */
table {
width: 100%;
border-collapse: collapse;
font-size: 11.5px;
}
th {
background: #0a3d62;
color: white;
padding: 6px 8px;
text-align: left;
font-weight: 700;
font-size: 10.5px;
text-transform: uppercase;
letter-spacing: 0.5px;
}
th:first-child { border-radius: 4px 0 0 0; }
th:last-child { border-radius: 0 4px 0 0; }
td {
padding: 6px 8px;
border-bottom: 1px solid #e2eaf3;
color: #2d3748;
vertical-align: middle;
}
tr:last-child td { border-bottom: none; }
tr:nth-child(even) td { background: #eef3f9; }
td.highlight { font-weight: 700; color: #0a3d62; }
td.red { color: #c0392b; font-weight: 700; }
td.green { color: #27ae60; font-weight: 700; }
td.orange { color: #e67e22; font-weight: 700; }
/* ===== PILL TAGS ===== */
.tag {
display: inline-block;
background: #1a6fa8;
color: white;
font-size: 9.5px;
font-weight: 700;
padding: 2px 7px;
border-radius: 20px;
margin: 2px 2px 2px 0;
text-transform: uppercase;
letter-spacing: 0.5px;
}
.tag.orange { background: #e67e22; }
.tag.red { background: #c0392b; }
.tag.green { background: #27ae60; }
.tag.teal { background: #0e8b8b; }
.tag.purple { background: #8e44ad; }
/* ===== BULLET LIST ===== */
ul.blist {
list-style: none;
padding: 0;
margin: 0;
}
ul.blist li {
font-size: 11.5px;
color: #2d3748;
padding: 3px 0 3px 16px;
border-bottom: 1px solid #edf2f7;
position: relative;
}
ul.blist li:last-child { border-bottom: none; }
ul.blist li::before {
content: "▸";
position: absolute;
left: 0;
color: #1a6fa8;
font-size: 10px;
top: 4px;
}
ul.blist li strong { color: #0a3d62; }
/* ===== SPAN COLS ===== */
.span2 { grid-column: span 2; }
.span3 { grid-column: span 3; }
/* ===== HF-20 HERO ===== */
.hf20-hero {
background: linear-gradient(135deg, #0a3d62 0%, #1a6fa8 100%);
border-radius: 10px;
padding: 18px 22px;
color: white;
display: grid;
grid-template-columns: 1fr 1fr 1fr 1fr;
gap: 14px;
}
.hf20-stat {
background: rgba(255,255,255,0.1);
border: 1.5px solid rgba(255,255,255,0.2);
border-radius: 8px;
padding: 10px 14px;
text-align: center;
}
.hf20-stat .s-val {
font-size: 22px;
font-weight: 900;
color: #5fd8e8;
display: block;
line-height: 1.1;
}
.hf20-stat .s-unit {
font-size: 10px;
color: #a8d8e8;
font-weight: 600;
}
.hf20-stat .s-label {
font-size: 10px;
opacity: 0.8;
margin-top: 4px;
}
/* ===== ALARM BOX ===== */
.alarm-box {
background: #fff5f5;
border: 2px solid #e53e3e;
border-radius: 8px;
padding: 8px 12px;
margin-top: 6px;
}
.alarm-box p {
font-size: 10.5px;
color: #c0392b;
font-weight: 600;
margin: 2px 0;
}
.alarm-title {
font-size: 11px;
font-weight: 800;
color: #c0392b;
text-transform: uppercase;
letter-spacing: 0.5px;
margin-bottom: 3px;
}
/* ===== WARN BOX ===== */
.warn-box {
background: #fffbf0;
border: 1.5px solid #f59e0b;
border-radius: 8px;
padding: 8px 12px;
margin-top: 6px;
}
.warn-box p {
font-size: 10.5px;
color: #92610a;
margin: 2px 0;
}
/* ===== FORMULA BOX ===== */
.formula {
background: #eef3f9;
border-left: 4px solid #1a6fa8;
border-radius: 0 6px 6px 0;
padding: 8px 12px;
font-size: 12px;
color: #0a3d62;
font-weight: 700;
margin: 8px 0 4px;
font-family: 'Courier New', monospace;
}
/* ===== FOOTER ===== */
.footer {
background: #0a3d62;
color: rgba(255,255,255,0.6);
font-size: 9.5px;
padding: 8px 32px;
display: flex;
justify-content: space-between;
}
/* ===== STEP BOXES ===== */
.steps {
counter-reset: step;
list-style: none;
padding: 0;
margin: 0;
}
.steps li {
counter-increment: step;
font-size: 11px;
color: #2d3748;
padding: 4px 4px 4px 26px;
border-bottom: 1px solid #edf2f7;
position: relative;
}
.steps li:last-child { border-bottom: none; }
.steps li::before {
content: counter(step);
position: absolute;
left: 2px;
top: 4px;
background: #1a6fa8;
color: white;
font-size: 9px;
font-weight: 700;
width: 16px;
height: 16px;
border-radius: 50%;
display: flex;
align-items: center;
justify-content: center;
line-height: 16px;
text-align: center;
}
.steps li strong { color: #0a3d62; }
</style>
</head>
<body>
<div class="poster">
<!-- HEADER -->
<div class="header">
<div class="header-left">
<h1>CRRT <span>Prescription</span> Reference</h1>
<p>Continuous Renal Replacement Therapy | Pediatric & Adult Weight-Based Dosing | HF-20 Focus</p>
</div>
<div style="display:flex; gap:14px;">
<div class="header-badge">
<div class="badge-title">Mode</div>
<div class="badge-main">CVVH / CVVHD / CVVHDF</div>
<div class="badge-sub">Continuous Venovenous</div>
</div>
<div class="header-badge">
<div class="badge-title">Machine</div>
<div class="badge-main">Prismaflex</div>
<div class="badge-sub">/ PrisMax / AQUARIUS</div>
</div>
</div>
</div>
<!-- BODY GRID -->
<div class="body">
<!-- ROW 1: HF-20 HERO + FILTER SELECTION -->
<!-- HF-20 HERO -->
<div class="span2">
<div class="section-label">⬛ HF-20 Filter – Key Specifications (Prismaflex Polysulfone)</div>
<div class="hf20-hero">
<div class="hf20-stat">
<span class="s-val">< 11 kg</span>
<span class="s-unit">Patient Weight</span>
<div class="s-label">Primary Indication<br>(Safe down to 2.3 kg)</div>
</div>
<div class="hf20-stat">
<span class="s-val">60 mL</span>
<span class="s-unit">Priming Volume</span>
<div class="s-label">+25 mL Hotline warmer<br>= 85 mL total ECV</div>
</div>
<div class="hf20-stat">
<span class="s-val">0.2 m²</span>
<span class="s-unit">Membrane Surface</span>
<div class="s-label">Polyarylethersulfone<br>High-flux membrane</div>
</div>
<div class="hf20-stat">
<span class="s-val">40–100</span>
<span class="s-unit">mL/min BFR</span>
<div class="s-label">Typical blood flow<br>On citrate: max 100 ml/min</div>
</div>
</div>
</div>
<!-- FILTER SELECTION -->
<div class="card card-blue">
<h3><span class="icon">🔵</span> Filter Selection by Weight</h3>
<table>
<tr>
<th>Filter</th>
<th>Weight</th>
<th>Prime Vol</th>
</tr>
<tr>
<td class="highlight">HF 20</td>
<td class="highlight">< 11 kg</td>
<td>60 mL</td>
</tr>
<tr>
<td>AN69 / ST60</td>
<td>11–30 kg</td>
<td>93 mL</td>
</tr>
<tr>
<td>ST100 / M100</td>
<td>> 30 kg</td>
<td>152–165 mL</td>
</tr>
<tr>
<td>ST150</td>
<td>> 60 kg</td>
<td>189 mL</td>
</tr>
</table>
<div class="warn-box">
<p>⚠ <strong>Blood prime needed</strong> if ECV > 10% patient blood volume (usually <8–10 kg)</p>
<p>Blood volume: <5 kg = 85 mL/kg | 5–20 kg = 80 mL/kg | >20 kg = 70 mL/kg</p>
</div>
</div>
<!-- ROW 2: DOSE TABLE + BFR TABLE + VASCULAR ACCESS -->
<!-- CRRT DOSE BY AGE -->
<div class="card card-teal">
<h3><span class="icon">💊</span> CRRT Dose by Age Group (Effluent Rate)</h3>
<table>
<tr>
<th>Group</th>
<th>Dose (mL/kg/h)</th>
<th>Notes</th>
</tr>
<tr>
<td class="highlight">Neonates</td>
<td class="green">20–35</td>
<td>Start 20, titrate up</td>
</tr>
<tr>
<td class="highlight">Children</td>
<td class="green">25–35</td>
<td>Higher catabolism</td>
</tr>
<tr>
<td class="highlight">Adolescents</td>
<td class="green">25–35</td>
<td>≈2–2.5 L/h if >50 kg</td>
</tr>
<tr>
<td class="highlight">Adults</td>
<td class="green">20–25</td>
<td>≈1.5–2.5 L/h total</td>
</tr>
<tr>
<td colspan="3" style="background:#fff9e6; padding:5px 8px; font-size:10.5px; color:#7d5a00;">
<strong>Standard adult dose:</strong> 25 mL/kg/h (KDIGO) — prescribe higher to account for downtime
</td>
</tr>
</table>
<div class="formula">Effluent (mL/h) = Dose × Weight (kg)</div>
</div>
<!-- BFR TABLE -->
<div class="card card-orange">
<h3><span class="icon">🩸</span> Blood Flow Rate (Qb) by Weight</h3>
<table>
<tr>
<th>Patient</th>
<th>mL/kg/min</th>
<th>Absolute BFR</th>
</tr>
<tr>
<td>Neonates / Infants</td>
<td class="orange">10–12</td>
<td>–</td>
</tr>
<tr>
<td>Children 4–12 yr</td>
<td class="orange">4–8</td>
<td>–</td>
</tr>
<tr>
<td>Adolescents</td>
<td class="orange">2–4</td>
<td>–</td>
</tr>
<tr>
<td>0–10 kg</td>
<td>–</td>
<td class="orange">30–60 mL/min</td>
</tr>
<tr>
<td>11–20 kg</td>
<td>–</td>
<td class="orange">50–100 mL/min</td>
</tr>
<tr>
<td>21–50 kg</td>
<td>–</td>
<td class="orange">100–150 mL/min</td>
</tr>
<tr>
<td>> 50 kg</td>
<td>–</td>
<td class="orange">150–200 mL/min</td>
</tr>
</table>
<p style="font-size:10px; color:#7d4e00; margin-top:6px;">⚠ HF20 on citrate: min 40 ml/min, max 100 ml/min. Max BFR = 400 mL/min/1.73m²</p>
</div>
<!-- VASCULAR ACCESS -->
<div class="card card-navy">
<h3><span class="icon">🩹</span> Vascular Access (CRRT Catheter)</h3>
<table>
<tr>
<th>Weight</th>
<th>Catheter</th>
</tr>
<tr>
<td>< 10 kg</td>
<td class="highlight">6.5 Fr Gamcath</td>
</tr>
<tr>
<td>10–20 kg</td>
<td class="highlight">8 Fr Gamcath</td>
</tr>
<tr>
<td>20–40 kg</td>
<td class="highlight">10 Fr Mahurkar</td>
</tr>
<tr>
<td>> 40 kg</td>
<td class="highlight">12 Fr Mahurkar</td>
</tr>
</table>
<ul class="blist" style="margin-top:8px;">
<li>Preferred site: <strong>Right internal jugular</strong> (RIJ)</li>
<li>6.5 Fr also used with <strong>arterial line</strong> for citrate</li>
<li>Temporary catheters preferred over tunneled in PICU</li>
<li>Most experienced person should insert</li>
</ul>
</div>
<!-- ROW 3: ANTICOAGULATION + HF-20 FLOW LIMITS + FLUID BALANCE -->
<!-- ANTICOAGULATION -->
<div class="card card-purple">
<h3><span class="icon">💉</span> Anticoagulation Options</h3>
<table>
<tr>
<th>Method</th>
<th>Protocol</th>
<th>Target</th>
</tr>
<tr>
<td class="highlight">Citrate (RCA)</td>
<td>Preferred for HF-20</td>
<td>iCa post-filter 0.25–0.35 mmol/L</td>
</tr>
<tr>
<td>Heparin</td>
<td>Bolus 10–30 U/kg<br>Infusion 5–20 U/kg/h</td>
<td>aPTT 1.5–2× (35–45s)<br>ACT 140–170 s (infant A)</td>
</tr>
<tr>
<td>LMWH<br>(Enoxaparin)</td>
<td>Load 0.15 mg/kg<br>Maintenance 0.05 mg/kg/h</td>
<td>Anti-Xa 0.25–0.35 U/mL</td>
</tr>
<tr>
<td>No anticoag</td>
<td>Saline flush 50–200 mL q30–60 min</td>
<td>Bleeding risk / coagulopathy</td>
</tr>
</table>
<div class="alarm-box" style="margin-top:6px;">
<div class="alarm-title">⛔ AN69 (ST/M-series) Caution</div>
<p>Discontinue ALL ACE inhibitors before AN69 use — risk of bradykinin release syndrome. HF-20 (polysulfone) does NOT carry this risk.</p>
</div>
</div>
<!-- HF-20 MAX FLOW LIMITS -->
<div class="card card-red">
<h3><span class="icon">⚙️</span> HF-20 Maximum Flow Limits (Prismaflex)</h3>
<table>
<tr>
<th>Parameter</th>
<th>Max Value</th>
<th>Notes</th>
</tr>
<tr>
<td>BFR (Qb)</td>
<td class="red">100 mL/min</td>
<td>On citrate; 40–100 usual</td>
</tr>
<tr>
<td>Dialysate (Qd)</td>
<td class="red">2350 mL/h</td>
<td>CVVHD/CVVHDF</td>
</tr>
<tr>
<td>Pre-filter Qr</td>
<td class="red">2500 mL/h</td>
<td>Replacement fluid pre</td>
</tr>
<tr>
<td>Post-filter Qr</td>
<td class="red">2000 mL/h</td>
<td>Replacement fluid post</td>
</tr>
<tr>
<td>UFR (net removal)</td>
<td class="red">3000 mL/h</td>
<td>Total ultrafiltration</td>
</tr>
<tr>
<td>Filtration Fraction</td>
<td class="red">< 25%</td>
<td>To prevent filter clotting</td>
</tr>
</table>
<p style="font-size:10px; margin-top:6px; color:#555;"><strong>Filtration Fraction</strong> = Post-filter Qr / (Plasma flow + Pre-filter Qr) × 100</p>
</div>
<!-- FLUID BALANCE / NET UF -->
<div class="card card-green">
<h3><span class="icon">🌊</span> Fluid Removal (Net UF) Goals</h3>
<ul class="blist">
<li><strong>Typical removal:</strong> 1–2 mL/kg/h net ultrafiltration</li>
<li><strong>5% body weight/day</strong> is aggressive (e.g., 500 mL/day for 10 kg)</li>
<li><strong>2 mL/kg/h</strong> = 20 mL/h net for 10 kg patient</li>
<li>Actual removal = UFR + Intake − Output</li>
<li>Fluid overload > 10% BW = consider CRRT initiation</li>
</ul>
<table style="margin-top:8px;">
<tr>
<th>Scenario</th>
<th>Net UF Rate</th>
</tr>
<tr>
<td>Maintenance</td>
<td>0.5–1 mL/kg/h</td>
</tr>
<tr>
<td>Fluid overloaded</td>
<td>1–2 mL/kg/h</td>
</tr>
<tr>
<td>Severe overload</td>
<td>2–4 mL/kg/h (closely monitored)</td>
</tr>
<tr>
<td>Rhabdomyolysis</td>
<td>80–100 mL/kg/h effluent (pre-dilution)</td>
</tr>
</table>
</div>
<!-- ROW 4: SPECIAL INDICATIONS + STEP-BY-STEP + MONITORING -->
<!-- SPECIAL INDICATIONS + HYPERAMMONEMIA -->
<div class="card card-teal">
<h3><span class="icon">🧪</span> Special Conditions – High-Dose CRRT</h3>
<table>
<tr>
<th>Indication</th>
<th>Effluent Dose</th>
<th>Mode</th>
</tr>
<tr>
<td>Hyperammonemia</td>
<td class="red">150–350 mL/kg/h<br>(4000–8000 mL/1.73m²/h)</td>
<td>CVVHDF<br>Dialysate-heavy</td>
</tr>
<tr>
<td>Rhabdomyolysis</td>
<td class="orange">80–100 mL/kg/h</td>
<td>CVVH Pre-filter</td>
</tr>
<tr>
<td>Tumour Lysis</td>
<td class="orange">35–50 mL/kg/h</td>
<td>CVVHD preferred</td>
</tr>
<tr>
<td>Sepsis-AKI</td>
<td class="green">25–35 mL/kg/h</td>
<td>Standard</td>
</tr>
</table>
<div class="formula" style="font-size:10.5px;">
Neonate (3.5 kg): 6000 mL/1.73m² × 0.25m² / 1.73 = 867 mL/h ≈ 248 mL/kg/h
</div>
</div>
<!-- STEP-BY-STEP PRESCRIPTION -->
<div class="card card-blue span2">
<h3><span class="icon">📋</span> Step-by-Step CRRT Prescription Checklist</h3>
<div style="display:grid; grid-template-columns:1fr 1fr; gap:12px;">
<ol class="steps">
<li><strong>Confirm indication:</strong> AKI, fluid overload, electrolyte/toxin, metabolic</li>
<li><strong>Weigh patient</strong> (dry weight or estimated ideal body weight)</li>
<li><strong>Select filter</strong> by weight: HF-20 (<11 kg), ST60 (11–30), ST100/150 (>30/60 kg)</li>
<li><strong>Blood prime?</strong> If ECV >10% blood volume → prime with pRBC:NS 1:1 or 5% albumin</li>
<li><strong>Choose mode:</strong> CVVH (convection), CVVHD (diffusion), CVVHDF (both)</li>
<li><strong>Set BFR (Qb):</strong> See weight-based table; HF-20 = 40–100 mL/min</li>
</ol>
<ol class="steps" style="counter-reset: step 6;">
<li><strong>Set effluent dose:</strong> 20–35 mL/kg/h (neonates/children); 20–25 mL/kg/h (adults). Prescribe 25–30% higher to compensate for downtime</li>
<li><strong>Anticoagulation:</strong> Citrate RCA preferred (especially HF-20); heparin if citrate contraindicated</li>
<li><strong>Net UF goal:</strong> Set desired fluid removal per hour based on fluid status</li>
<li><strong>Replacement fluid:</strong> Type (lactate vs. bicarbonate-based), pre vs. post dilution</li>
<li><strong>Labs before start:</strong> iCa, electrolytes, ABG, coagulation panel, arterial line recommended (citrate)</li>
<li><strong>Monitor:</strong> Filter life, citrate toxicity (iCa ratio), pressures, circuit alarms q4h</li>
</ol>
</div>
</div>
<!-- MONITORING + LABS -->
<div class="card card-orange span3">
<h3><span class="icon">🔔</span> Monitoring, Alarms & Troubleshooting</h3>
<div style="display:grid; grid-template-columns:1fr 1fr 1fr; gap:14px;">
<div>
<div class="section-label">Filter Life Optimization</div>
<ul class="blist">
<li>Target filter life <strong>> 24 h</strong></li>
<li>Keep filtration fraction <strong>< 25%</strong></li>
<li>Pre-dilution reduces clotting risk</li>
<li>Adequate BFR reduces clotting</li>
<li>Citrate anticoagulation: longer life</li>
<li>Minimize circuit interruptions</li>
</ul>
</div>
<div>
<div class="section-label">Citrate Toxicity Signs</div>
<ul class="blist">
<li><strong>iCa systemic low</strong> (<1.1 mmol/L) but post-filter low</li>
<li>Metabolic alkalosis (if excess)</li>
<li>Increasing citrate dose need</li>
<li>Anion gap elevation</li>
<li>Monitor: post-filter iCa q6h; systemic iCa q4h</li>
<li>Total Ca : iCa ratio >2.5 = toxicity</li>
</ul>
</div>
<div>
<div class="section-label">Pre-CRRT Checklist Labs</div>
<ul class="blist">
<li>Ionized calcium — correct if iCa <1.1 mmol/L before start</li>
<li>ABG / metabolic acidosis → NaHCO₃ 1 mmol/kg if severe</li>
<li>K⁺, Na⁺, PO₄³⁻, Mg²⁺, BUN, Creatinine</li>
<li>Coagulation (PT/aPTT/fibrinogen)</li>
<li>CBC — platelets</li>
<li>Arterial line strongly recommended for citrate</li>
</ul>
</div>
</div>
</div>
</div><!-- end body -->
<!-- FOOTER -->
<div class="footer">
<span>References: KDIGO AKI Guidelines | Burkholder et al. CRRT Prescribing Recommendations (2023) | IntechOpen Pediatric CRRT Monitoring (2024) | Prismaflex HF-20 Technical Specifications</span>
<span>For clinical use under physician supervision only — verify doses against local protocols</span>
</div>
</div>
</body>
</html>
Running Command
which wkhtmltopdf && wkhtmltopdf --page-size A3 --orientation Landscape --enable-local-file-access /home/daytona/workspace/crrt-poster/crrt_hf20_poster.html /home/daytona/workspace/crrt-poster/CRRT_HF20_Prescription_Poster.pdf 2>&1 | tail -5
Running Command
which chromium-browser || which chromium || which google-chrome || which google-chrome-stable || which puppeteer 2>/dev/null; python3 -c "import weasyprint; print('weasyprint ok')" 2>&1
Running Command
chromium --headless --disable-gpu --no-sandbox --print-to-pdf=/home/daytona/workspace/crrt-poster/CRRT_HF20_Prescription_Poster.pdf --print-to-pdf-no-header "file:///home/daytona/workspace/crrt-poster/crrt_hf20_poster.html" 2>&1 | tail -5
Running Command
ls -lh /home/daytona/workspace/crrt-poster/
Your CRRT poster is ready. Download both formats below:
CRRT HF20 Prescription Poster
PDF Document · PDF
crrt hf20 poster
HTML File · HTML
What's on the poster (full content summary)
HF-20 Filter - Key Specs
| Parameter | Value |
|---|---|
| Patient weight | < 11 kg (safe down to 2.3 kg) |
| Priming volume | 60 mL + 25 mL warmer (Hotline) = 85 mL total ECV |
| Membrane | Polyarylethersulfone / Polysulfone, 0.2 m² |
| BFR | 40–100 mL/min (citrate: min 40, max 100) |
Filter Selection by Weight (Prismaflex)
| Filter | Weight | Priming Volume |
|---|---|---|
| HF-20 | < 11 kg | 60 mL |
| AN69 M60 / ST60 | 11–30 kg | 93 mL |
| ST100 / M100 | > 30 kg | 152–165 mL |
| ST150 | > 60 kg | 189 mL |
Blood prime required if ECV > 10% of patient blood volume (usually < 8–10 kg). Blood volume: < 5 kg = 85 mL/kg; 5–20 kg = 80 mL/kg; > 20 kg = 70 mL/kg.
Weight-Based CRRT Dose (Effluent Rate)
| Group | Dose (mL/kg/h) | Notes |
|---|---|---|
| Neonates | 20–35 | Start 20, titrate |
| Children | 25–35 | Higher catabolism |
| Adolescents | 25–35 | ~2–2.5 L/h if > 50 kg |
| Adults | 20–25 (KDIGO: 25) | Prescribe higher to cover downtime |
Formula: Effluent (mL/h) = Dose × Weight (kg)
Blood Flow Rate (Qb)
| Patient | mL/kg/min | Absolute |
|---|---|---|
| Neonates / Infants | 10–12 | – |
| Children 4–12 yr | 4–8 | – |
| 0–10 kg | – | 30–60 mL/min |
| 11–20 kg | – | 50–100 mL/min |
| 21–50 kg | – | 100–150 mL/min |
| > 50 kg | – | 150–200 mL/min |
HF-20 Maximum Flow Limits
| Parameter | Maximum |
|---|---|
| BFR on citrate | 100 mL/min |
| Dialysate Qd | 2350 mL/h |
| Pre-filter Qr | 2500 mL/h |
| Post-filter Qr | 2000 mL/h |
| UFR (net removal) | 3000 mL/h |
| Filtration Fraction | < 25% |
Anticoagulation
- Citrate (RCA) - preferred for HF-20; iCa post-filter target 0.25–0.35 mmol/L
- Heparin - bolus 10–30 U/kg, infusion 5–20 U/kg/h; target aPTT 1.5–2x
- LMWH - enoxaparin load 0.15 mg/kg, maintenance 0.05 mg/kg/h; anti-Xa 0.25–0.35 U/mL
- No anticoag - saline flush 50–200 mL q30–60 min
Note: Polysulfone HF-20 does NOT carry risk of bradykinin release syndrome (unlike AN69 membranes - stop ACE inhibitors before AN69 use).
Special Conditions - High-Dose CRRT
| Condition | Effluent Dose |
|---|---|
| Hyperammonemia | 150–350 mL/kg/h (4000–8000 mL/1.73 m²/h) |
| Rhabdomyolysis | 80–100 mL/kg/h (pre-filter CVVH) |
| Tumour Lysis | 35–50 mL/kg/h |
| Sepsis-AKI | 25–35 mL/kg/h standard |
Sources: KDIGO AKI Guidelines | Burkholder et al. Pediatric CRRT Prescribing Recommendations (2023) | IntechOpen Pediatric CRRT Monitoring (2024) | Prismaflex HF-20 Technical Specifications.
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