Replacement fluid of continuous veno-venous hemofiltration
Choice of replacement fluid buffer:
HCO3 (+ heparin to prevent clotting, although can be run heparin-free)
citrate: hepatically metabolized to HCO3, ∴ cannot be given in cirrhosis/liver failure. Provides anticoag w/in machine via Ca chelation. Citrate toxicity: ↓ iCa but nl/ ↑ serum Ca and AG met acidosis.
Dose adjust for solute and volume removal (AJKD 2016;68:645)