课件：CRR的临床应用与护理潘淼.ppt

精心护理－－关注细节 保持管道通畅、预防感染 全面观察：注意生命体征、压力变化 液体平衡：根据病情准确调整、计算正确 内环境稳定：及时采集标本 及时记录 药物使用注意： 根据血药浓度调整用药时间与量 间断血液滤过，滤后给药 准备、进行 保持管道通畅 抗凝 前稀释 冲洗：NS 减少采样口取血 不要轻易停止血泵 护理记录 置管时间、术中经过 导管局部情况 CRRT开始时间 平衡要求 每小时出入量及平衡 THANK YOU SUCCESS * * 可编辑 * CRRT is the blanket term which encompasses all continuous therapies. It has been defined as…. Read the slide. Make sure to note the proof source. * CRRT acronyms…. Read slide. * This schematic represents a hemofilter (hemodialyzer). Note that there is a semipermeable membrane separating the blood and fluid compartments. Blood exerts a positive pressure on the membrane as it passes from the patient, through the filter, and returns back to the patient. On the fluid side of the filter, a low pressure exists. It is the combination of these positive and negative pressures that together make up the transmembrane pressure (TMP). By adjusting the TMP we can regulate the amount of ultrafiltrate removed. The higher the pressure gradient, the more fluid removed. * As this slide shows, the circuit for SCUF is a simple one. Blood enters the extracorporeal circuit through an access line, passes through the hemofilter, and returns to the patient circulation via the return line. As the blood passes through the filter, ultrafiltration takes place and effluent collects in the effluent bag. Effluent is any fluid that exits the hemofilter and is delivered to a waste bag. Pumps control blood flow and fluid removal rates. * In the schematic we can see how solutes travel from the high concentration of the blood side into the low concentration of the dialysate side. Dialysate prescription is adjusted to preserve necessary components and remove unwanted metabolites. Note that dialysate flow is established counter-current to the blood flow. This serves to increase effectiveness and maximize clearance. * This schematic depicts a CVVHD circuit. The dialysate is pumped through the fluid side of the filter counter-current to the blood flow. In CV