课件：SanfordFlexBasicCRRheoryrev.ppt

* It is imperative that CRRT is continuously monitor for the following parameters: Blood pressure, Patency of circuit,Hemodynamic stability,Level of consciousness, Acid/base balance, Electrolyte balance, Hematological status, Infection,Nutritional status, Air embolus, Blood flow rate, Ultrafiltration flow rate, Dialysate/replacement flow rate, Alarms and responses, Color of ultrafiltrate/filter blood leak, Color of CRRT circuit. * There are a variety of reasons as to why CRRT is terminated, but the decision is made by the nephrologist or the prescribing physician. Termination may occur, because patient have gained renal recovery, patient status-recovery, or the patient or family have decided to terminate therapy. Your unit will have designed a protocol for discontinuing the treatment as well as vascular access care. * Dr. Ronco set forth to study answer the question “What is the adequate dose for the ARF patient?” thus began the journey to find this dose. The origin of ARF was mostly post surgical with the other causes from medical and trauma related. Sepsis was also prevalent throughout the study participants. Dr. Ronco selected 492 patients for the study, but 67 of those patient were excluded. Some of the 425 patients were actually randomized into the study, and assigned to one of the three doses: 20ml/kg/hr, 35ml/kg/hr, and 45ml/kg/hr. The study was conducted using only convection therapy. All replacement solution was delivered post-filter, and UFR was used to measure dosing. Why did he use UFR to measure dosing. Well, it is known that solute movement across the membrane is proportional to UFR. For example, Urea has a sieving coefficient of 1 it is then assumed that it is equal to UFR. Therefore, ultrafiltration rate corresponds with clearance, and can be used as a surrogate treatment dose. * This is a another way to visually see the outcome from Dr. Ronco’s study. Group 1 is what we consider conventional delivery with poor patient outcome. Grou