【持续性肾脏替代治疗CRRT英文ppt课件】Regional Citrate Anticoagulation (RCA) in CRRT.pptVIP

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2018-07-20 发布于贵州
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【持续性肾脏替代治疗CRRT英文ppt课件】Regional Citrate Anticoagulation (RCA) in CRRT.ppt

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【持续性肾脏替代治疗CRRT英文ppt课件】Regional Citrate Anticoagulation (RCA) in CRRT

Regional Citrate Anticoagulation (RCA) in CRRT;Overview;CRRT circuit;Anticoagulation for CRRT;Contact activation by membrane;Impact of filter clotting;Anticoagulation options;Continuous renal replacement therapy: B.E.S.T. Kidney (The Beginning and Ending Supportive Therapy for the kidney).a worldwide practice survey. 23 Countries, 54 ICUs, 1006 patients with ARF on CRRT;;;Mechanism of Regional Citrate Anticoagulant;Fate of the citrate calcium complex in the CRRT circuit;What is the citrate dose required?;To achieve a steady state whole blood citrate conc. of 4 mmol/L;Citrate dose;;;Citrate Formulation;Difference between TSC and ACDA;;Complex metabolic consequence of using RCA;Citrate - Solutions Requirements;Advantage of RCA;Less clotting in Hollow Fibers membrane Kid Int 1999;Longer Filter Life;Less Bleeding Episode;Less Transfusion requirement;Use of citrate CVVH was safer and reduced mortality CCM37:545-552(2009);Hospital mortality 41 vs 57% (p=0.03)3-month Mortality 45 vs 62% (p=0.02);Disadvantage of RCA;Metabolic complication of RCA CRRT;Citrate clearance;Citrate Clearance;Citrate;First description of Citrate-CVVHD;RCA CRRT circuit Options;Palsson and Niles KI 1999;55:1991-7;Who can do that ? ;PYNEH ICU (1995-2003);PYNEH ICU ( 2004 …..;Clues to the success use of RCA;Blood flow requirements for CRRT to maintain filtration fraction at 25%;Filtration Fraction;Filtration Fraction;;PYICU RCA CRRT regime;Problem from non-integrated approach;Fresenius Ci-Ca system;Fresenius Ci-Ca System;Ci-Ca System: Completely Integrated Regional Citrate Anticoagulation;Fresenius Ci-Ca System;Ci-Ca Dialysate solution;A Safe Citrate Anticoagulation Protocol CCM 2009;37:2018-24;RCA—Finally on its way to standardization?;Gambro Prismaflex;RCA with Gambro Prismaflex;Solution for RCA--Gambro;Prismocitrate and PrismOcal for RCA;Citrate dose in Gambro RCA;RCA circuit in Gambro Prismaflex;Gambro vs Fresenius;Monitoring during RCA CRRT;Titration of ionized Calcium;Titration o