文档介绍：CRRT的局部枸橼酸抗凝
ICU中急性肾脏功效衰竭*: BEST Kidney
患病率
1738/29269 (%, 95%CI – %)
危险原因
感染性休克(%, 95%CI – %)
住院病死率
% (95%CI – %)
*少尿(< 200 ml/12 hr)和(或)显著氮质血症(BUN > 84 mg/dL)
Uchino S, Kellum JA, Bellomo R, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA ; 294: 813-818
急性肾功效衰竭定义: RIFLE标准
GFR标准
UO标准
Risk
肌酐增加x > 25%
UO < ml/kg/hr x 6 hr
Injury
肌酐增加x 2或GFR降低> 50%
UO < ml/kg/hr x 12 hr
Failure
肌酐增加x 3或GFR降低> 75%
UO < ml/kg/hr x 24 hr
或无尿x 12 hr
Loss
持续ARF = 肾脏功能完全丧失> 4周
ESRD
终末期肾病> 3月
Bellomo R, Ronco C, Kellum JA, et al. Acute renal failure: definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care ; 8: R204-R212
ICU 急性肾脏损伤(AKI)
Ostermann M, Chang RWS. Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med ; 35: 1837-1843
%
急性肾功效衰竭诊疗(n = 646)
Perez-Valdivieso JR, Bes-Rastrollo M, Monedero P, et al. Prognosis and serum creatinine levels in acute renal failure at the time of nephrology consultation: an observational cohort study. BMC Nephrology ; 8: 14-22
连续肾脏替换诊疗管路寿命
满足诊疗要求
降低诊疗费用
降低重新安装管路护理时间
18 – 30 hr
Holt AW, Bierer P, Glover P, Plummer JL, Bersten AD. Conventional coagulation and thromboelastograph parameters and longevity of continuous renal replacement circuits. Intensive Care Med ; 28: 1649-55.
Stefanidis I, Hagel J, Frank D, Maurin N. Hemostatic alterations during continuous venovenous hemofiltration in acute renal failure. Clin Nephrol 1996; 46(3): 199-205.
Kox WJ, Rohr U, Waurer H. Practical aspects of renal replacement therapy. Int J Artif Organs 1996; 19: 100-5.
Tan HK, Baldwin I, Bellomo R. Continuous veno-venous haemofiltration without anticoagulation in high-risk patients. Intensive Care Med ; 26: 1652-7.
连续