【正文】 26(7):12081212.44.8(6):701707.43.27(10):22242228.42.30(4):301307.41. 534528.40. Biancofiore G, Esposito M, Bindi L, et al. Regional filter heparinization for continuous venovenous hemofiltration in liver transplant recipients. Minerva Anestesiol. Jun 2003。 Oudemansvan Straaten HM, Wester JP, de Pont AC, et al. Anticoagulation strategies in continuous renal replacement therapy: can the choice be evidence based? Intensive Care Med. Feb 2006。 Bagshaw SM, Laupland KB, Boiteau PJ, et al. Is regional citrate superior to systemic heparin anticoagulation for continuous renal replacement therapy? A prospective observational study in an adult regional critical care system. J Crit Care. Jun 2005。 Hirsh J, Raschke R. Heparin and lowmolecularweight heparin: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. Sep 2004。 Monchi M, Berghmans D, Ledoux D, et al. Citrate vs. heparin for anticoagulation in continuous venovenous hemofiltration: a prospective randomized study. Intensive Care Med. Feb 2004。 Singer M, McNally T, Screaton G, et al. Heparin clearance during continuous venovenous haemofiltration. Intensive Care Med. 1994。 Shulman RI, Singer M, Rock J. Continuous renal replacement therapy. Keeping the circuit open: lessons from the lab. Blood Purif. 2002。 de Pont AC, Bouman CS, Bakhtiari K, et al. Predilution versus postdilution during continuous venovenous hemofiltration: a parison of circuit thrombogenesis. Asaio J. JulAug 2006。 Uchino S, Fealy N, Baldwin I, et al. Predilution vs. postdilution during continuous venovenous hemofiltration: impact on filter life and azotemic control. Nephron Clin Pract. 2003。 van der Voort PH, Gerritsen RT, Kuiper MA, et al. Filter run time in CVVH: pre versus postdilution and nadroparin versus regional heparinprotamine anticoagulation. Blood Purif. 2005。 Ramesh Prasad GV, Palevsky PM, Burr R, et al. Factors affecting system clotting in continuous renal replacement therapy: results of a randomized, controlled trial. Clin Nephrol. Jan 2000。 Davies H, Leslie G. Maintaining the CRRT circuit: nonanticoagulant alternatives. Aust Crit Care. Nov 2006。 Opatrny K, Jr., Polanska K, Krouzecky A, et al. The effect of heparin rinse on the biopatibility of continuous venovenous hemodiafiltration. Int J Artif Organs. Jun 2002。 Hirasawa H, Oda S, Matsuda K. Continuous hemodiafiltration with cytokineadsorbing hemofilter in the treatment of severe sepsis and septic shock. Contrib Nephrol. 2007。 Nakada TA, Oda S, Matsuda K, et al. Continuous hemodiafiltration with PMMA Hemofilter in the treatment of patients with septic shock. Mol Med. MayJun 2008。 Haase M, Silvester W, Uchino S, et al. A pilot study of highadsorption hemofiltration in human septic shock. Int J Artif Organs. Feb 2007。 Morgera S, Haase M, Kuss T, et al. Pilot study on the effects of high cutoff hemofiltration on the need for norepinephrine in septic patients with acute renal failure. Crit Care Med. Aug 2006。 Morgera S, Haase M, Rocktaschel J, et al. High permeability haemofiltration improves peripheral blood mononuclear cell proliferation in septic patients with acute renal failure. Nephrol Dial Transplant. Dec 2003。 Palsson R, Laliberte KA, Niles JL. Choice of replacement solution and anticoagulant in continuous venovenous hemofiltration. Clin Nephrol. Jan 2006。 Heering P, Ivens K, Thumer O, et al. The use of different buffers during continuous hemofiltration in critically ill patients with acute renal failure. Intensive Care Med. Nov 1999。 Barenbrock M, Hausberg M, Matzkies F, et al. Effects of bicarbonate and lactatebuffered replacement fluids on cardiovascular oute in CVVH patients. Kidney Int. Oct 2000。 Maccariello E, Rocha E, Dalboni MA, et al. Customized bicarbonate buffered dialysate and replacement solutions for continuous renal replacement therapies: effect of crystallization on the measured levels of electrolytes and buffer. Artif Organs. Nov 2001。 Aucella F, Di Paolo S, Gesualdo L. Dialysate and replacement fluid position for CRRT. Contrib Nephrol. 2007。 Thomas CM, Zhang J, Lim TH, et al. Concentration of heparinlocking solution and risk of central venous hemodialysis catheter malfunction. Asaio J. JulAug 2007。 Kellum JA, Mehta RL, Angus DC, et al. The first international consensus conference on continuous renal replacement therapy. Kidney Int. Nov 2002。 Canaud B, Chenine L, Henriet D, et al. Optimal management of central venous catheters for hemodialysis. Contrib Nephrol. 2008。 Leblanc M, Fedak S, Mokris G, et al. Blood recirculation in temporary central catheters for acute hemodialysis. Clin Nephrol. May 1996。 Canaud B, Desmeules S, Klouche K, et al. Vascular access for dialysis in the intensive care unit. Best Pract Res Clin Anaesthesiol. Mar 2004。 Klouche K, Amigues L, Deleuze S, et al. Complications, effects on dialysis dose, and survival of tunneled femoral dialysis catheters in acute renal failure. Am J Kidney Dis. Jan 2007。299(20):24132422.11.156(275286.10. Tordoir J, Canaud B, Haage P, et al. EBPG on Vascular Access. Nephrol Dial Transplant. May 2007。9(3):R266273.8. Gotch FA. Kt/V is the best dialysis dose parameter. Blood Purif. 2000。30(2):124132.6. Ronco C, Bellomo R, Homel P, et al. Effects of different doses in continuous venovenous haemofiltration on outes of acute renal failure: a prospective randomised trial. Lancet. Jul 1 2000。6(5):429433.4. Rogiers P, Zhang H, Pauwels D, et al. Comparison of polyacrylonitrile (AN69) and polysulphone membrane during hemofiltration in canine endotoxic shock. Crit Care Med. Apr 2003。13(6):385402.2.注：（Lp＞20）；低通量濾器（Lp＜10）. Lp系單位面積膜超濾系數(shù)，單位為mL/⒉置換 (透析) 液速率和血流速率可根據(jù)實(shí)際情況調(diào)整⒊Qb、Qf、 QdAV SCUF低低高或低通量50～100無(wú)無(wú)溶質(zhì)清除效率低CAVHDF高高高通量50～1003510～20利于中、小分子溶質(zhì)清除CAVHD低高高或低通量50～100無(wú)10～20設(shè)備簡(jiǎn)單，溶質(zhì)清除率低CAVH高低高通量50～1008～20無(wú)血流動(dòng)力學(xué)穩(wěn)定，可連續(xù)清除水分和溶質(zhì)，但溶質(zhì)清除效率低，動(dòng)脈護(hù)理困難h)Qd(mL/min)表3