【正文】 CRRT對ARF腎功能恢復(fù)的影響 －CRRT促進(jìn)腎功能恢復(fù)。ng)的可能途徑,1,2,第三十六頁，共四十四頁。nli224。 356: 26 30,第十九頁，共四十四頁。,1989－1997：100例創(chuàng)傷(chuāngshāng)后ARF 早期－后期的臨界：BUN 60mg/dl 兩組病人創(chuàng)傷評分、GCS、發(fā)生休克的比例、年齡、性別和創(chuàng)傷分布均無差異,早期－后期(h242。 2 days Everyotherday:16 177。,Mode of RRT differences among continents,Bellomo, et al. 2001,Understanding Renal Replacement Therapy and Acute Renal Failure in the ICU (The B.E.S.T kidney study),第三頁，共四十四頁。j236。 60: 1154 63 Kellum JA. Continuous versus intermittent RRT. A metaanalysis. Intensive Care Med 2002。,Dose and Timing of CVVH in ARF,Bouman CS, et al. Critical Care Med 2002。,RENAL,Multicenter RCT (centers = 35) N= 1500 Australia and New Zealand 25 ml/kg/hr vs. 40 ml/kg/hr of CVVHDF Outcome: all cause mortality at 90 days Currently under way,第二十五頁，共四十四頁。,脈沖式高容量血液(xu232。 delivered duration: 8.43177?？赡芙档臀Ｖ夭∪说牟∷缆?第四十四頁，共四十四頁。,CVVH + 血漿吸附對感染性休克(xiūk232。,HVCVVH明顯改善感染性休克(xiūk232。,ATN (n=1260),Multicenter RCT in the USA. Patients with ARF randomized to: Intensive Management Strategy: If hemodynamically stable (SOFA CVS score: 02) IHD 6times/week (target Kt/V =1.21.4/session) If hemodynamically unstable (SOFA CVS score: 34) CVVHDF at 35 ml/kg/hr or SLED 6times/week (target Kt/V = 1.21.4/session) Conventional Management Strategy: If hemodynamically stable (SOFA CVS score: 02) IHD 3times/week (target Kt/V =1.21.4/session)。 2436L/24 h) Late lowvolume hemofiltration (n=36。,Mortality: Which is better CRRT or IHD?,Swzrtz. RD. Comparing continuous HF with HD in patients with severe ARF Am J Kidney 1999。ngm224。)的影響 －CRRT促進(jìn)腎功能恢復(fù),Crit Care Med 2003。 346:305310,為什么CRRT有助于腎臟功能(gōngn233。,早期－后期(h242。 30: 2205 (n=106),第二十頁，共四十四頁。li224。,Higher Uf volumes,Higher membrane cutoff,Permeability,Convection,Grootendorst AF et al , 1992 Bellomo R et al, 1998,Leese T et al. 1987 Berlot G et al. 1997,1,2,Use of sorbents in combination therapies,Adsorption,Ronco C et al. 1999 Tetta C et al. 20