(精选)【持续性肾脏替代治疗CRRT英文精品课件】dialytic therapy in acute renal failure - low res教学课件.ppt

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2018-03-21 发布于天津
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(精选)【持续性肾脏替代治疗CRRT英文精品课件】dialytic therapy in acute renal failure - low res教学课件.ppt

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Dialytic therapy in Acute Renal Failure – starting from square one;Outline;Background;Background;Background;;AC Fry et al PostgradMedJ 2006;82:106-111;;Linear increase in odds ratio from Risk to Failure (Odds ratios, Risk 2.5, Injury 5.4, Failure 10.1);;;;;;;;;;;;;Practical problems in dialytic therapy in ARF;Why to start?;When to start?;When to start? – Ur / Cr level ?;Benefits and risks;Early initiation of RRT;Early initiation of RRT;Early initiation of RRT;Early initiation of RRT;Early initiation of RRT;Valerie et al. Seminar in dialysis Vol 17, No 1 (Jan –Feb) 2004, p30-36;Confounding factors;Timing of initiation - Conclusion ;What to start? IHD vs. CRRT;;Why CRRT ? ;Is CRRT more superior ?;Raymond Vanholder et al. J Am Soc Nephrol 12:S40-43,2001;Mehta et al;Mehta et al;Comment from Claudio RoncoClin J Am Soc Nephrol 2:597-600;Mehta et al Kidney Int 60: 1154-1163,2001;Vinsonneau et al Hemoleaf study Group;Vinsonneau et al Lancet 368:379-385, 2006;Vinsonneau et al Hemoleaf study Group;Tonelli et al. AJKD 40:875-885,2002;Modality of RRT - conclusion;Choice of dialysers;Biocompatibility;Bio-incompatible membranes (e.g. Cuprophane, hemophane);Membrane biocompatibility;;With the cost differential between bioincompatible and biocompatible dialysers used in ARF settling rapidly diminishing, there remains no persuasive reason to use unsubstituted cellulose dialysers. Hemodialysis in ARF: Does the membrane matter? Modi GS et al. Seminars in Dialysis Vol 14 No 5 (Sept-Oct) 2001 p318-332;Dialytic dose in ARF;;;;;URM in ARF;;Only 15-32% of treatment sessions achieved Kt/V 1.2. Teehan GS et al. J Intensive Care Med 2003; 18; 130;UKM and clinical outcomes in ARF;;;Schiffl et al NEJM 2002;346:305-310;Schiffl et al NEJM 2002;346:305-310;UKM in CRRT;;Ronco et alLancet 356:26-30,2000;;How to compare dialytic doses in different modalities?;Artificial organs 30:178-185;;;;;Dialytic dose - Conclusion ;;;AC Fry et al Postgrad Med J 2006; 82:106-116;;Conclusion;Future di