CRRT抗凝选择分析.pptVIP

* * 枸橼酸与肝素相比滤器寿命 Kutsogiannis DJ, Gibney RTN, Stollery D et al. Regional citrate versus systemic heparin anticoagulation for continuous renal replacement in critically ill patients. Kidney Int 2005; 67: 2361-2367 与肝素相比，可降低患者病死率 hospital and 3-month mortality rates were 15% lower in the citrate than in the nadroparin group citrate Heleen M. Crit Care Med,2009 , 37( 2):545-552. * Oudemans-van .Intensive Care Med (2006) 32:188–202 * * * * * * 枸橼酸局部抗凝方案: 抗凝监测 R heater ACD-A V V PV PA UF BLD SAD 枸橼 酸钙 动脉标本 外周静脉或动脉 游离钙1.10 – 1.30 mmol/L 静脉标本 滤器后血滤管路 游离钙0.25 – 0.35 mmol/L 枸橼酸局部抗凝方案: 抗凝监测 Q2h x 4 Q4h