Van Malderen P, De Rijck L, Vermaut M, Van Leuven G, De Bolle G, Billiouw J M, Lornoy W, Becaus I
Haemodialysis Department, O.L.V. Ziekenhuis, Aalst, Belgium.
EDTNA ERCA J. 1998 Oct-Dec;24(4):19-20.
Various renal replacement therapies have been used for the treatment of acute renal failure in critically ill patients in the last decade. Due to the slower rate of solute and fluid removal, the continuous renal replacement therapies are generally better tolerated than conventional therapy. There is no consensus whether different treatment strategies effect the outcome of critically ill patients and no clear definition of adequacy of renal support in the severely ill patient. Despite their possible benefits, the continuous renal replacement therapies place major demands on the organisation and workload in the dialysis unit. Having taken this into consideration our unit has opted for a ten hours daytime intermittent venovenous haemodiafiltration technique as an alternative for patients in severe conditions of haemodynamic instability, the so-called "go slow" dialysis.
在过去十年中,各种肾脏替代疗法已被用于治疗危重症患者的急性肾衰竭。由于溶质和液体清除速度较慢,连续性肾脏替代疗法通常比传统疗法耐受性更好。对于不同的治疗策略是否会影响危重症患者的预后,目前尚无共识,对于重症患者肾脏支持的充分性也没有明确的定义。尽管连续性肾脏替代疗法可能有其益处,但对透析单元的组织和工作量提出了重大要求。考虑到这一点,我们科室选择了一种十小时的日间间歇性静脉-静脉血液透析滤过技术,作为血流动力学不稳定严重患者的替代方案,即所谓的“慢透析”。