CRR及其护理原创.ppt

* The goal of a Hemofilter is to mimic (copy) some of the functions of the kidneys particularly the excretory functions, i.e. remove waste products, like urea and creatinine, and excess fluid from the blood to maintain homeostasis in the body. This is essential for the regulation of the water and electrolyte (dissolved salts) balance and for the body to maintain normal acid-base balance. At the same time, while removing some of the metabolic wastes I have just mentioned, the kidneys do not allow the removal of essential compounds such as albumin and haemoglobin. * Ultrafiltration is the removal of fluid through the use of positive and negative pressures exerted on either side of the membrane. In CRRT, the positive pressure, or push, is coming from the blood compartment of the hemofilter as the blood pump pushes the blood into the hollow fibers. The negative pressures, or pull, is coming from the fluid compartment of the hemofilter according to the programmed fluid removal rate by the clinician. The total amount of pressures exerted on the membrane is called the transmembrane pressure or TMP. Ultrafiltration rate is the term used for rate of fluid removal; and ultrafiltrate is the product of the fluid removal or the effluent in CRRT. * Diffusion is defined as the movement of Solutes from an area of higher concentration to an area of lower concentration Hemodialysis uses the principle of diffusion to remove small solutes from the blood, through the addition of dialysate into the fluid side of the filter, on the other side of the semi-permeable membrane. In hemodialysis, solutes that are in abundance in the blood will move to the dialysate compartment where the level is lower. * Hemofiltration uses convection to remove solutes of bigger molecular weight, by increasing the fluid removal or ultrafiltration rate. This process is also called “solvent drag”. The fluid removed is replaced with a solution of equal volume. This solution is called a replacement solution. Th