Continuous renal replacement therapy (CRRT) is an important support treatment technique for critically ill patients. Anticoagulation is a crucial part for CRRT. High bleeding risk, hypercoagulability, liver failure, and tissue hypoperfusion are very common in critically ill patients. Patients with these conditions, neonate/infant patients, and old patients need special considerations on clearance of anticoagulant and the efficacy and safety of anticoagulation for CRRT. Therefore, bleeding risk, coagulation status, metabolism characteristics of anticoagulation drug, and treatment needs should be considered when tailored anticoagulation strategies are chosen for CRRT in these patients. Additionally, closely monitoring of the relevant indicators and side effects are needed, and dosage and mode of different anticoagulants should be adjusted in a timely manner.
连续性肾脏替代治疗（CRRT）是危重症患者重要的支持治疗技术，抗凝是CRRT的关键环节。危重症患者常常合并高危出血、高凝状态、肝功能衰竭、组织低灌注等临床情况，这些患者以及高龄、新生儿/婴幼儿等在抗凝剂的代谢、有效性、安全性上具有一定的特殊性。综合考虑患者出血风险、凝血风险、药物代谢特点、治疗需求，才能为这些患者提供适宜的CRRT个体化抗凝方案。治疗过程中，需密切监测不同抗凝剂相关指标和不良反应，及时调整抗凝剂量和模式。.