Patel Reena, Pirret Alison M, Mann S, Sherring Claire L
Department of Intensive Care Medicine, Middlemore Hospital, New Zealand.
Intensive Crit Care Nurs. 2009 Feb;25(1):45-9. doi: 10.1016/j.iccn.2008.09.001. Epub 2008 Oct 16.
Renal replacement therapy (RRT) is a common therapy used to treat critically ill patients in acute renal failure. Currently a number of dialysis modalities are used such as haemodialysis, continuous renal replacement therapy (CRRT), and sustained low efficiency dialysis (SLED). As SLED is a recently implemented RRT, very little literature is available on the nursing aspects of SLED. This paper shares the local nursing experience of using SLED, thus providing a nursing perspective. Between 2002 and 2006, 103 patients were treated with SLED resulting in 307 SLED treatments. Early problems encountered involved patient hypotension, dialysis catheter patency and water quality; all of which were overcome by initially commencing dialysis at a lower prescribed blood pump rate, using larger catheters and improving water quality. Nursing advantages of SLED over CRRT included being able to release the patient for nursing activities and patient transfer out of the ICU for investigations and procedures; reduced nursing workload related to less machine and patient monitoring during the dialysis procedure; and cost reduction. Disadvantages of SLED are related to poor water quality, accessibility of water supply and limited space to house the two machines required. SLED has proven to be a nurse friendly dialysis modality for critically ill patients with acute renal failure.
肾脏替代疗法（RRT）是用于治疗急性肾衰竭重症患者的常用疗法。目前使用多种透析方式，如血液透析、连续性肾脏替代疗法（CRRT）和持续性低效透析（SLED）。由于SLED是最近才实施的RRT，关于SLED护理方面的文献非常少。本文分享了使用SLED的当地护理经验，从而提供一种护理视角。在2002年至2006年期间，103例患者接受了SLED治疗，共进行了307次SLED治疗。早期遇到的问题包括患者低血压、透析导管通畅性和水质问题；所有这些问题都通过最初以较低的预设血泵速率开始透析、使用更大的导管和改善水质得以克服。与CRRT相比，SLED的护理优势包括能够让患者腾出时间进行护理活动以及转出重症监护病房（ICU）进行检查和操作；在透析过程中因减少对机器和患者的监测而降低护理工作量；以及降低成本。SLED的缺点与水质差、供水便利性以及安置所需两台机器的空间有限有关。事实证明，对于急性肾衰竭重症患者，SLED是一种对护士友好的透析方式。
