20xx年醫(yī)學(xué)專題—crrt：嚴(yán)重膿毒癥與mods(邱海波)-資料下載頁
2024-10-31 17:01本頁面
【正文】 uced sepsis James R. Matson, Crit Care Med, 26: 730737, 1998,Cutoff 100 KD,第三十七頁，共四十四頁。,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. 2001,3,促進(jìn)介質(zhì)(ji232。zh236。)清除/遏制炎癥反應(yīng)的可能途徑,第三十八頁，共四十四頁。,Coupled plasmafiltrationadsorption, by regenerating the plasmafiltrate, avoids unwanted losses, avoids the contact of RBC, WBC and platelets with the sorbent, and prevents treatment induced thrombocytopenia.,,Hemodiafilter,Plasmafilter,Dialysate 30 ml/min,Plasmafilter,20 ml/min,100200 ml/min,第三十九頁，共四十四頁。,CPFA: Hemodynamics and Biological Effects,P 0.01,NA,MAP,at 10 hours of treatment versus baseline,D Norepinephrine Dose and D+ MAP,0,20,40,60,80,100,%,P 0.01,TNF Prod.,Phagocytosis,D Monocyte TNF production and Phagocytic Capacity,P 0.01,0,500,1000,1500,%,at 10 hours of treatment versus baseline,pg/ml,P 0.05,第四十頁，共四十四頁。,CVVH + 血漿吸附對感染性休克(xiūk232。)血流動力學(xué)的影響 Hemodynamic response to coupled plasmafiltrationadsorption in human septic shock,N=12 mechanically ventilated pats with septic shock Intervention: A median of 10 consecutive sessions (prescribed treatment time: 10 h/session。 delivered duration: 8.43177。1.37 h/min) of coupled plasmafiltrationadsorption,Intensive Care Med (2003) 29:703–708,第四十一頁，共四十四頁。,CRRT in ICU,Early CRRT: 改善創(chuàng)傷(chuāngshāng)合并ARF患者的預(yù)后 CRRT vs IRRT： CRRT可能促進(jìn)腎臟功能恢復(fù) 可能降低危重病人的病死率 Use 45 ml/kg.min for CVVH for septic shock pats Way to increase mediators clearance: PHVHF vs CPFA,第四十二頁，共四十四頁。,Thanks for you attention,第四十三頁，共四十四頁。,內(nèi)容(n232。ir243。ng)總結(jié),CRRT Severe sepsis and MODS。CRRT對ARF腎功能恢復(fù)的影響 －CRRT促進(jìn)腎功能恢復(fù)。35/ml/kg/h。45ml/kg/h。兩組病人創(chuàng)傷評分、GCS、發(fā)生休克(xiūk232。)的比例、年齡、性別和創(chuàng)傷分布均無差異。早期－后期CRRT對危重病患者的影響 －早期或預(yù)防性CRRT可降低ARF患者病死率。2436L/24 h)?？赡芙档臀Ｖ夭∪说牟∷缆?第四十四頁，共四十
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