Department of Intensive Care Medicine, Austin Hospital, Melbourne, Vic., Australia.
Blood Purif. 2011;32(1):1-6. doi: 10.1159/000323035. Epub 2011 Jan 15.
In vasopressor-dependent patients, we evaluated the impact of a slow blood flow protocol on hypotension when starting continuous renal replacement therapy (CRRT).
Retrospective observational study in tertiary ICU of a slow blood flow protocol at the start of CRRT circuits.
205 circuits in 52 patients were studied. No significant changes in mean arterial pressure (MAP) and norepinephrine dose were found. Only 16 circuit starts in 13 patients were associated with a decrease in MAP >20%. In 23 filters and 11 patients, norepinephrine dose was >50 μg/min at baseline and also did not change significantly. There were no cardiac arrests or ventricular arrhythmias and CRRT was not discontinued because of hypotension.
Implementation of a CRRT slow blood flow protocol in vasopressor-dependent patients enabled the initiation of CRRT circuits with limited hemodynamic consequences and no cardiac arrest or ventricular arrhythmia.
在依赖血管加压素的患者中，我们评估了在开始连续肾脏替代治疗（CRRT）时使用缓慢血流方案对低血压的影响。
对三级 ICU 中 CRRT 回路开始时使用缓慢血流方案的回顾性观察性研究。
研究了 52 名患者的 205 个回路。平均动脉压（MAP）和去甲肾上腺素剂量均无显著变化。仅在 13 名患者的 16 个回路启动时 MAP 下降>20%。在 23 个滤器和 11 名患者中，基线时去甲肾上腺素剂量>50μg/min，也无明显变化。没有心跳骤停或室性心律失常，也没有因低血压而停止 CRRT。
在依赖血管加压素的患者中实施 CRRT 缓慢血流方案，可在有限的血流动力学后果下启动 CRRT 回路，且不会发生心跳骤停或室性心律失常。
