(精编)【持续性肾脏替代治疗CRRT英文精品课件】CITRATE ANTICOAGULATION —STATE OF THE ART AND BEYOND.pptVIP

* Possible reactions to impaired citrate metabolism during Ci-Ca CVVHD for critically ill patients. Fallbeispiel: Metabolische Alkalose Fallbeispiel: Metabolische Alkalose / keine Zitratakkumulation * * * This graph shows the frequent development of alkalosis particularly during the initial phase of the treatment. This was a clinical disadvantage of this procedure, in addition to the relatively low standard dose of 1 L/h (far below the recommendation of Ronco et al.) * multiFiltrate with Ci-Ca module ? * Benefits due to the integration of the citrate pump * Added safety by the integrated calcium pump * Flow Scheme highlighting that a total of five flows are selectable. Therefore, up to five independent goals can be achieved by flow adjustments. * Standard screen during the treatment, emphasising the setting parameters for the citrate-specific goals * Continuation of the established operating concept. Here, as an example, the set-up instructions. * Representation with set-up of the Ci-Ca cassette The correct set-up is supported by several design details: -?? the guiding of the citrate line on the cassette supports the intuitive set-up - top = top (for the citrate line) and bottom = bottom (for the calcium line) - Adjusted line lengths prevent additionally wrong insertions of citrate and calcium line components - Colour coding Green: Citrate White: Calcium * Clear benefits due to the double-lumen tubings and a permanent connection * Continuation of the established operating concept. Here, as an example, the set-up instructions. * Comparison of two studies on filter times with heparin and citrate. There was no difference in the filter times in the heparin groups of the two studies. However, the filter times with citrate were clearly better in the Monchi et al. study Explanation: The citrate dose in the Gabutti et al. study is obviously too low. A citrate dose of approx. 4 mmol/l is appropriate. * Proposal for prescription and adjustment of the citrate