Venkataraman Ramesh, Kellum John A, Palevsky Paul
Department of Critical Care Medicine, University of Pittsburgh School of Medicine and Veteran's Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15261, USA.
J Crit Care. 2002 Dec;17(4):246-50. doi: 10.1053/jcrc.2002.36757.
We sought to retrospectively review the dosing patterns of continuous renal replacement therapy (CRRT) in patients with acute renal failure (ARF) and determine their actual delivered dosage of CRRT.
Computerized records of patients (n = 115) who received CRRT for ARF at a single, large, academic, tertiary care hospital from September 1, 1999 through August 31, 2000 were reviewed. The delivered dose of CRRT for each patient/day was calculated from the hourly effluent flow rate, the patient's weight, and the duration (in hours) of CRRT for that day. A mean effluent flow rate (in L/h) for each patient was then calculated.
The average number of hours/day on CRRT was 16.1 +/- 3.53 (mean +/- SD), with a mean flow rate (averaged over 24 h) of 1.36 +/- 0.31 L/h. The mean CRRT dose prescribed for these patients was 24.46 +/- 6.73 mL/Kg/h, but the mean dose delivered was only 16.55 +/- 5.41 mL/Kg/h (68% of the prescribed dose, P <.000001).
Many patients are prescribed low doses of CRRT. Furthermore, the dose delivered is considerably lower than that prescribed. Methods and procedures to extend CRRT system life may improve the dose delivery.
我们试图回顾性分析急性肾衰竭（ARF）患者连续肾脏替代治疗（CRRT）的剂量模式，并确定其实际接受的CRRT剂量。
回顾了1999年9月1日至2000年8月31日在一家大型学术性三级医疗中心接受ARF的CRRT治疗的患者（n = 115）的计算机记录。根据每小时的流出液流速、患者体重以及当天CRRT的持续时间（小时）计算每位患者每天的CRRT剂量。然后计算每位患者的平均流出液流速（L/h）。
CRRT每天的平均时长为16.1±3.53（均值±标准差），平均流速（24小时平均值）为1.36±0.31L/h。这些患者的CRRT处方平均剂量为24.46±6.73mL/kg/h，但实际平均剂量仅为16.55±5.41mL/kg/h（为处方剂量的68%，P<.000001）。
许多患者接受的CRRT剂量较低。此外，实际给予的剂量远低于处方剂量。延长CRRT系统使用寿命的方法和程序可能会提高剂量输送。
