(精选)【持续性肾脏替代治疗CRRT英文精品课件】Pre ICU training ARF CRRT教学课件.pptVIP

CVVHDF配置簡圖 CVVHDFContinuous Veno-Venous Hemodiafiltration P R I S M A S CVVHDF order l??? Prepare Heparin 2cc + N/S 3cc, then inject 1.6cc into each femoral cath. l? For AK priming: (GAMBRO, Polyarylethersulfone, 6S) *1st N/S 1000cc. *2nd Heparin 2,500U. *3rd N/S 500cc. l???? *Prepare Heparin 25,000U + N/S 500cc IVD 10cc/hr with pump to keep aPPT 1.5-2? and adjust as followed: aPPT bolus hold dose(cc/hr) 1.0? 2000U - +4 1.0-1.5? - - +2 1.5-2.0? - - - 2.0-2.5? - 30min -2 2.5? - 60min -4 Pre ICU trainingARF CRRT 林承叡 May 19, 2007 Definition of ARF rapid decrease the renal function or urine output ↑Cr0.5mg/dl, or ↑Cr50%, or ↓GFR50% (1) Prerenal ARF, prerenal azotemia(-55%) diseases/that cause renal hypoperfusion without compromising integrity of renal parenchyma (2) intrinsic renal ARF, renal azotemia (-40%) diseases that directly involve renal parenchyma (3) postrenal ARF, postrenal azotemia (-5%). diseases associated with urinary tract obstruction Indications for dialysis Clinical evidence (symptoms or signs) of uremia Intractable intravascular volume overload Hyperkalemia or severe acidosis resistant to conservative measures Prophylactic dialysis when urea 100-150 mg/dL or creatinine 8-10 mg/dL CRRT AV: arteriovenous circuit VV: venovenous circuit Convection technique: UF, Hemofiltration Diffusion technique: solute gradient HDF: hemodiafiltration: small and middle molecules CAVH (continuous arteriovenous hemofiltraton), CAVHD (continuous arteriovenous hemodialysis), CVVH (continuous venous-venous hemodialysis), CVVHD (continuous venous-venous hem