肾脏替代治疗基础及原理-中级版(2011.3.12)__幻灯片.pptVIP

* Pre-dilution uses more replacement fluid to achieve same effect with post-dilution, so increases the cost for treatment 在透析器内血液侧的液体超滤到膜外，伴随着液体的移动，清除了中分子物质。 * : Post-dilution was associated with reduced filter life without any beneficial effect on daily changes in urea and creatinine levels. Pre-dilution appears a preferable technical approach to CVVH. Uchino S, Fealy N, Baldwin I, Morimatsu H, Bellomo R. Department of Intensive Care, Austin Repatriation Medical Centre, Melbourne, Vic., Australia.2003 * * 辅助治疗：原发病治疗，控制血压/血脂，营养，EPO, 补铁，控制血磷等 * Targeting at different group of solutes at different disciplinary disease: renal/cardiac/hepatic/hemo/ clinical limitation practical limitation: Different machines, facilities, not versatile ; CRRT combined several kind of that together, more flexible and useful CCPD=APD, because it uses a cycler, so… * 解释术语。Hypovolaemia lead to renal blood supply insufficient comorbid with heart failure or coronary problem; Fluid inflow: antibiotics+transfusion/plasma expander+ parenteral nutrition; Electrolyte imbalance, acid base imbalance; Sepsis; hyperthermia; cardiac failure; ARDS; transplantation ; more and more new field; chemotherapy derived renal failure. Continuous veno-venous hemofiltration may improve survival from acute respiratory distress syndrome after bone marrow transplantation or chemotherapy. DiCarlo JV, Alexander SR, Agarwal R, Schiffman JD. Division of Pediatric Critical Care Medicine, Stanford University Medical School and Lucile Packard Childrens Hospital, Palo Alto, California 94304, USA. jdicarlo@stanford.edu * From renal aspects describe the perspects of time. * Introduced balancing system, monitoring…. * Low efficiency , good for remove water only. Solute must add dialysis or filtration. * * Qd=50~200ml/min * Basically in CRRT, the solution used for dialysis and for hemofiltration is regarded as same and can interchange, because the standard of sterilization has been improved to the same