Background

The Advanced version (dubbed “UltraCalc”) builds on the basic version by introducing additional inputs and calculations for a more precise and tailored UF rate calculation. UltraCalc is a dynamic CRRT UF Rate Calculator designed for ICU clinicians to handle real-time, intelligent fluid balance calculations during CRRT. It adapts to changing inputs and scenarios with precision and flexibility.

UltraCalc calculates time remaining in shifts based on the clock, dynamically adjusting intake and UF rates as the shift progresses. Day shift users can select their accountability percentage for the 24-hour goal using a slider, providing flexibility in goal distribution. All inputs, including primary IV rates, enteral rates, and outputs, update calculations in real-time, ensuring accuracy and minimizing errors.

The calculator provides a detailed breakdown, showing predicted intake volume, remaining 24-hour goals, shift-specific fluid balance goals, total output, required gross output, and the suggested UF rate. It distinguishes between day and night shifts, tailoring calculations to match each shift’s unique responsibilities.

UltraCalc streamlines CRRT management by promoting precision, flexibility, and user-centered design, making it intuitive and easy to use even in high-pressure environments. The name highlights its advanced capabilities, elevating CRRT UF calculations beyond a basic tool.

How To

Enter the current net fluid balance.
Input the prescribed 24-hour net fluid balance goal, which is the target fluid balance for the entire day, such as -1000 mL for removing 1 liter.
Select the shift type (Day or Night). For Day Shift, use the magnitude slider to adjust the percentage of the 24-hour goal you want to be accountable for.
The program automatically calculates remaining time in the shift in hours and minutes. The calculator adjusts UF accordingly.
Input the hourly rate for primary IV fluids and enteral intake, as well as the total volume of secondary IV fluids predicted for the shift. These values represent the patient’s expected fluid intake during the shift.
Enter the hourly output rates for urine, NGT or OGT output, and drains. These values reflect the patient’s current or expected fluid losses from these sources during the shift.
Review the dynamically updated results. The calculator will display the predicted intake, shift-specific goal, total output, gross CRRT output needed to meet the goal, and suggested UF rate based on the remaining time. Note: If the UF rate is calculated to be negative, it will display as “0 mL/hr.” Negative UF rates are not possible because the CRRT machine cannot infuse fluid back into the patient to adjust for over-removal. Instead, a UF rate of “0” indicates no additional fluid should be removed by the machine during the shift. This typically reflects cases where the patient is already meeting their fluid balance goal through natural outputs (e.g., urine, drains) or minimal fluid intake.
Modify input values as needed to reflect changes in the patient’s intake, output, or shift details. The results will automatically recalculate to reflect these adjustments.
Use the reset button to clear all inputs and reset the results to default values, allowing you to start a new calculation.

This advanced version provides a more detailed and precise calculation of UF rates by including multiple sources of fluid intake and output, as well as adjustments for varying shift lengths.

UltraCalc

Section 1: Current Fluid Balance

Current Net Fluid Balance (mL):

Prescribed 24-Hour Net Goal (mL):

Section 2: Shift Details

Shift Type:

Day Shift Magnitude (% of 24-Hour Goal):
50%

Time Remaining

Hours Remaining: 0 hours

Minutes Remaining: 0 minutes

Section 3: Predicted Cumulative Intake

Primary IV Fluids Rate (mL/hr):

Secondary IV Fluids (Total mL):

Enteral Intake Rate (mL/hr):

Section 4: Outputs

Urine Output (mL/hr):

NGT/OGT Output Rate (mL/hr):

Drain Output Rate (mL/hr):

Results

Suggested UF Rate: 0.00 mL/hr

Calculation Breakdown:

Predicted Intake Volume: 0.00 mL
Remaining 24-Hour Goal: 0.00 mL
Shift-Specific Net Fluid Balance Goal: 0.00 mL
Total Output: 0.00 mL
Required Gross CRRT Output for the Shift: 0.00 mL

ADVISORY: The term “predictive” in this calculator refers to the user making a calculation based on their clinical acumen and the assumption that fluid volumes and rates—such as intake and output—will not significantly change or vary over time. While the calculator provides a framework for estimating ultrafiltration rates and meeting fluid balance goals, it relies on the user to input accurate data and account for potential variability in fluid administration or losses.

This assumption is important to recognize, as clinical conditions can evolve, and unforeseen factors may alter the predicted volumes. Users should re-evaluate and adjust inputs as necessary to ensure the calculation remains reflective of the patient’s real-time needs and circumstances. The predictive nature of the tool is intended to aid decision-making but does not replace clinical judgment or the need for ongoing assessment.