【持续性肾脏替代治疗CRRT英文精品课件】Acute Renal Replacement Therapy for the Infant.pptVIP

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2018-06-06 发布于浙江
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【持续性肾脏替代治疗CRRT英文精品课件】Acute Renal Replacement Therapy for the Infant.ppt

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【持续性肾脏替代治疗CRRT英文精品课件】Acute Renal Replacement Therapy for the Infant

Acute Renal Replacement Therapy for the Infant Dr.Fahad Gadi, MD Pediatrics Demonstrator King Abdulaziz University Rabigh Medical School Objectives Indications and goals for acute renal replacement therapy Modalities for renal replacement therapy Peritoneal dialysis Intermittent hemodialysis Continuous renal replacement therapy (CRRT) Special issues related to the infant Indications for Renal Replacement Volume overload Metabolic imbalance Toxins (endogenous or exogenous) Inability to provide needed daily fluids due to insufficient urinary excretion Goals of Renal Replacement Restore fluid, electrolyte and metabolic balance Remove endogenous or exogenous toxins as rapidly as possible Permit needed therapy and nutrition Limit complications Renal Replacement for the Infant: A Set of Special Challenges Small size of the patient Equipment designed for larger people Small blood volume will magnify effects of any errors Achieving access may be difficult Staff may have infrequent experience Modalities for Renal Replacement Peritoneal dialysis Intermittent hemodialysis Continuous renal replacement therapy (CRRT) Modalities for Renal Replacement Peritoneal dialysis Intermittent hemodialysis Continuous renal replacement therapy (CRRT) PD: Considerations for Infants ADVANTAGES Experience in the chronic setting No vascular access No extracorporeal perfusion Simplicity ? Preferred modality for cardiac patients? DISADVANTAGES Infectious risk Leak ? Respiratory compromise? Sodium sieving Dead space in tubing Modalities for Renal Replacement Peritoneal dialysis Intermittent hemodialysis Continuous renal replacement therapy (CRRT) IHD: Considerations for Infants ADVANTAGES Rapid particle and fluid removal; most efficient modality Does not require anticoagulation 24h/d DISADVANTAGES Vascular access Complicated Large extracorporeal volume Adapted equipment ? Poorly tolerated Modalities for Renal Replacement Peritoneal dialysis Intermittent hemodialysis Continuous renal replacement t