Ricci Zaccaria, Ronco Claudio
Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Hospital, Rome, Italy.
Contrib Nephrol. 2007;156:197-202. doi: 10.1159/000102084.
The application of information technology (IT) to the field of critical care nephrology is a process that may reduce errors in care delivery, improve monitoring, decrease unintentional practice variation, increase the quality and accuracy of delivered treatments.
This review presents some examples of potential applications of recent IT achievements to clinical practice.
The adequacy calculator for continuous therapy dose prescription was recently shown to accurately predict urea clearance. When clearances above 60 ml/min where prescribed, the calculator tended to overestimate effective clearances; this overestimation generally remained within an error of 15%. Nevertheless, the delivered Kt/V in 24 h will always approach the target value of 1.2. The use of the calculator enabled strict monitoring of treatments. Furthermore, the so-called 'next generation' machines have technical characteristics in common that allow the highest safety and accuracy levels: some of these aspects are addressed and commented on in the present review.
IT is having and will likely have a significant impact on patient safety, practice variation, patient assessment and monitoring, and documentation of the demographics of acute renal failure and dialysis. One of the most recent and potentially interesting aspects of IT implementation on acute dialysis might be the renal replacement dose monitoring and calculation: close control of the therapy delivery and, eventually, prescription adjustments might be optimized.
将信息技术（IT）应用于重症监护肾脏病领域是一个可能减少护理失误、改善监测、减少无意的操作差异、提高所提供治疗的质量和准确性的过程。
本综述展示了近期IT成果在临床实践中的一些潜在应用实例。
连续治疗剂量处方的充足性计算器最近被证明能准确预测尿素清除率。当处方清除率高于60 ml/min时，该计算器往往会高估有效清除率；这种高估一般仍在15%的误差范围内。然而，24小时内所达到的Kt/V将始终接近目标值1.2。使用该计算器能够严格监测治疗情况。此外，所谓的“下一代”机器具有共同的技术特征，可实现最高的安全性和准确性水平：本综述对其中一些方面进行了探讨和评论。
IT正在并可能继续对患者安全、操作差异、患者评估与监测以及急性肾衰竭和透析的人口统计学记录产生重大影响。IT在急性透析中的最新且可能最有趣的一个方面可能是肾脏替代剂量的监测和计算：密切控制治疗实施并最终优化处方调整。
