【持续性肾脏替代治疗crrt英文精品课件】dialysis in the critically

《【持续性肾脏替代治疗crrt英文精品课件】dialysis in the critically》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、DialysisintheCriticallyIllFellow’sconferenceCherylPirozzi,MDFebruary15,2012www.pyroenergen.com/.../dialysis-treatment.jpgOutlineAKIintheICUPrinciplesofRRTModesofRRTIndicationsforRRTOptimaltiming:WhentostartandstopOptimalmodality:WhentousewhatOptimaldosingRRTinspecificc

2、linicalsituationsConclusionsAKIintheICUAKIiscommonintheICUDependingondefinitionofAKI,upto50-60%ofpatientsintheICUUpto70%ofthesewillrequireRRTIndependentriskfactorformortality,50-60%mortalityincriticallyillMiller'sAnesthesia,7thed.2009Rondon-Berrios.CurrOpinNephrolHyper

3、tens.2007Mar;16(2):64-70.Foot.CurrentAnaesthesiaandCriticalCare2005;16:321-329AKIintheICUTreatmentofacutekidneyinjury(AKI)isprincipallysupportive--renalreplacementtherapy(RRT)indicatedinpatientswithseverekidneyinjury.Goal:optimizationoffluid&electrolytebalanceMultiplem

4、odalitiesofRRT:Intermittenthemodialysis(IHD),continuousrenalreplacementtherapies(CRRTs)hybridtherapies,iesustainedlow-efficiencydialysis(SLED)Foot.CurrentAnaesthesiaandCriticalCare2005;16:321-329PrinciplesofdialysisDialysis=diffusion=passivemovementofsolutesacrossasemi

5、-permeablemembranedownconcentrationgradientGoodforsmallmolecules(Ultra)filtration=convection=solute+fluidremovalacrosssemi-permeablemembranedownapressuregradient(solventdrag)Betterforremovaloffluidandmedium-sizemoleculesFaber.NursinginCriticalCare2009;14:4Foot.CurrentA

6、naesthesiaandCriticalCare2005;16:321-329PrinciplesofdialysisMiller'sAnesthesia,7thed.2009Foot.CurrentAnaesthesiaandCriticalCare2005;16:321-329Hemodialysis=solutepassivelydiffusesdownconcentrationgradientDialysateflowscountercurrenttobloodflow.Urea,creatinine,Kmovefromb

7、loodtodialysateCaandbicarbmovefromdialysatetoblood.Hemofiltration:useshydrostaticpressuregradienttoinducefiltration/convectionplasmawater+solutesacrossmembrane.Hemodiafiltration:combinationofdialysisandfiltration.ModalityofRRTIntermittenthemodialysis(IHD)Continuousrena

8、lreplacementtherapy(CRRT)PeritonealdialysisHybridtherapies,likeSLEDDIntermittenthemodialysis(IHD)Oldestandmostcommont