危重病CRRT治疗课件

1、危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗Blood InBlood InBlood OutBlood Outto wasteto waste(from patient)(from patient)(to patient)to patient)HIGH PRESSHIGH PRESSLOW PRESSLOW PRESSReplRepl. .SolutionSolutionCVVHCVVHContinuous Continuous VenoVeno- -Venous Venous HemofiltrationHemofiltration(Convection)(Co

2、nvection)危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗Anatomy of a Hemofilterblood inblood inblood outdialysateindialysateoutOutside the Fiber (effluent)Inside the Fiber (blood)Cross Sectionhollow fiber membrane危重病CRRT治疗透析透析高渗高渗低渗低渗滤过滤过高压高压低压低压危重病CRRT治疗HEMODIALYSISDiffusionHEMOFILTRATION :Convection危重病CRRT治疗ReplRepl.

3、 .SolutionSolutionDialysateSolutionBlood InBlood InBlood OutBlood Outto wasteto waste(from patient)(from patient)(to patient)(to patient)HIGH PRESSHIGH PRESSLOW PRESSLOW PRESSHIGH CONCHIGH CONCLOW CONCLOW CONCCVVHDFCVVHDFContinuous Continuous VenoVeno- -Venous Venous HemodiafiltrationHemodiafiltrati

4、on(Diffusion)(Diffusion)(Convection)(Convection)危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗CRRT由治疗肾衰由治疗肾衰 救治救治MODS危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗Q QUFUF (100-300 mL/hr) (100-300 mL/hr)Vol control, minimal solute clearance!Ultrafiltration vol = Pts Wt lossQ

5、QB B (50-100 mL/min) (50-100 mL/min)High permeable filter危重病CRRT治疗Q QUFUF (500-2000 mL/hr) (500-2000 mL/hr)PredilutionPostdilutionConvective solute removalClearance for all solutes =UFHigh permeable filterQ QB B (50-200 mL/min) (50-200 mL/min)危重病CRRT治疗DialysateDialysateQ QDiDiQ QDoDoDiffusive solute

6、 removalLimited small soluteQ QUFUF = Q = Q Di Di Q Q DoDo (100-300 mL/hr)(100-300 mL/hr)Q QB B (50-200 mL/min) (50-200 mL/min)Low permeable dialyzer with Countercurrent flow through Dialyzer compartment危重病CRRT治疗DialysateDialysateQ QDiDiQ QDoDoQ QUFUF = Q = Q Di Di Q Q DoDo (100-300 mL/hr)(100-300 mL/hr)PostdilutionConvective + Diffusive solute removalSmall to large moleculePredilutionHigh permeable dialyzer with Countercurrent flow through Dialyzer compartment危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重病CRRT治疗危重