I've been taking care of a patient on CRRT. That's continuous dialysis because a patient is too unstable to tolerate big shifts in fluid (in and out of the body). In addition to cleaning the blood, it's also used to help pull off extra fluid we've given through IV's, meds, etc.
Basically, what goes in must come out, right? While that sounds great in theory, some disease states makes that a very difficult request. Sometimes the patient just flat out needs more fluid for his/her blood pressure, regardless of what problems all that extra fluid may cause.
The numbers sound all nice and round, but they're really not. With a flush here and there, changing volumes of continuous drips, and various volumes of meds (ie: 4.44 mL), you just work meticulously with your numbers and do the best you can.
Which is why when my patient's net gain over the past day was +167.2 mL, and I pulled off 67.2 mL over two hours to give myself an even +100, I got really excited. Down to the tenth of a mL?! I rock.
Or something.
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