血液净化技术护理导论.pptVIP

CRRT--CBP--ECT 连续性肾脏替代治疗 CRRT（ Continuous Renal Replacement Therapy ) 连续性血液净化治疗 CBP ( Continuous Blood Purifilcation) 体外循环生命支持系统 ECT （Extracorporeal treatment） 指所有连续性清除溶质，对脏器功能起支持作用的 各种血液净化技术 再循环的定义 公式：％R=P-A/P-V×100 可发生在单针透析、双腔导管及PTFE内瘘中，降低透析效率 导管位置和导管长度对再循环率有影响 置入小静脉 、血流量低，重复循环高，透析效率降低40% 我们在临床该做什么？ 配液 换液 冲水 计算 调整 记录 为了确保CRRT的治疗效果，从事透析 的医生护士的技术和经验比任何透析形式要更加重要。 * * Typical Pressures During Treatment Access pod measures the extracorporeal pressure as the blood “exits” the vascular access. The access pressure is measured to prevent excessive suction by the blood pump. This pressure is measured before the blood pump and is always negative; typically -50 to -150 mmHg. Filter pod measures the extracorporeal pressure as the blood enters the hemofilter. Filter pressure is measured after the blood pump and is always positive. Since it is measured before the hemofilter, it is the most positive (highest) pressure in the PRISMA Set; typically +100 to +250 mmHg. Return pod measures the extracorporeal pressure as the blood re-enters the vascular access. This measurement prevents return of blood to the vascular access against excessive resistance. The return pressure is measured after the blood pump and is always positive; typically +50 to +150 mmHg. Effluent pod measures the pressure in the effluent line as the ultrafiltrate “exits” the hemofilter. Depending on the therapy chosen and the ultrafiltration rate, the effluent pressure can be positive or negative; typically +50 to -150 mmHg. All pressures above, except the access pressure, provide data needed by PRISMA software to calculate transmembrane pressure and filter pressure drop. These calculations are used to provide information that may indicate that clotting has begun in the filter or that the filter has clotted and the PRISMA Set must be changed. During patient treatment, actual pressures at each pod can be viewed on the Status screen. * Typical Pressures During Treatment Acces