金宝CRRT的操作方法.ppt

1、操作完毕，整理用物。500ml/L含氯消毒剂擦拭机身。处理完毕后，备用。 2、仪器负责人定期清洁检查仪器，有记录 【维护保养】 Thank you！ * * As mentioned earlier, replacement fluids may be administered pre or post filter. Pre-filter replacement fluids are often referred to as “pre-dilutional” fluids. Pre-dilution fluids are used to dilute the blood prior to entering the filter so that the blood HCT is lower. The benefit of pre-dilution is the prevention of hemoconcentration and reduction of filter clotting. Hemoconcentration occurs when too much plasma water is removed from the blood causing it to “thicken” and clot. In order to maintain precise fluid balance, the amount of pre-dilution replacement fluid is removed from the EC circuit by ultrafiltration. Therefore some of the replacement fluid is immediately removed. The question becomes then, how much is removed? It is difficult to say. Some people say 10-15%. The more fluid replacement infused and removed, the better the convective clearance of small and middle molecules. * Post dilution fluid replacement ensures that the patient receives the total electrolyte/buffer concentration contained in the fluid. As with Pre-dilution administration of replacement solution, the volume of fluid used is what drives the convective clearance. The benefits received from pre-dilution replacement are not present with post-dilution replacement. Therefore there may be a need to increase anticoagulation to prevent filter clotting. A benefit that post-dilution replacement fluid does offer is that the effluent (UF) chemistries truly reflect the plasma solute losses and thus filter efficiencies. The UF vs. plasma chemistry value is an important measure of filter efficiency. (Discuss FUN/BUN ratios if desired.) * * * * * * * * * 金宝CRRT的操作 邓丽梅  一.概念及基本原理 二. CRRT上机操作 三. CRRT的液体配置与抗凝 四.CRRT的报警及处理 金宝prismaflex SCUF CVVH CVVHD CVVHDF CRRT临床指征 血流动力学不稳定的ARF 严重的SIRS—重症胰腺炎，烧伤 重症感染和感染性休克 MODS与ARDS 水中毒与急性肺水肿 顽固性心衰 中毒 恶性高热 容量治疗受限的ARF/CAF 1. 专用于枸橼酸抗凝的PBP泵 2. 一体化的抗凝模式 3. 完善的加热