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分体式持续静脉-静脉血液滤过在重症急性肾损伤中的疗效

Efficacy of separated system continuous venovenous hemofiltration in critical acute kidney injury.

作者信息

Susantitaphong Paweena, Tiranathanagul Khajohn, Srisawat Nattachai, Katavetin Pisut, Praditpornsilpa Kearkiat, Eiam-Ong Somchai

机构信息

Extracorporeal Multiorgan Support Dialysis Center of Excellence Department of Medicine, Division of Nephrology, Center of Excellence for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Ther Apher Dial. 2011 Oct;15(5):475-80. doi: 10.1111/j.1744-9987.2010.00880.x. Epub 2010 Nov 22.

Abstract

Integrated system continuous venovenous hemofiltration (CVVH), the most popularly utilized mode for continuous renal replacement therapy (CRRT), needs a sophisticated and expensive machine that is available only in limited critical care units. Separated system CVVH, which can be simply set up, might be an effectively alternative to CRRT. A one-year prospective observational study regarding the efficacy of separated system CVVH was conducted with 192 critically ill patients with acute kidney injury. All patients underwent separated system CVVH with the pre-dilution mode and a mean CVVH dose of 34.9±2.7mL/kg/h. The APACHEII score was 23.2±8.4 and the Sequential Organ Failure Assessment score was 12.0±4.3. No complications, including air-embolism or circuit clotting, were observed and the survival rate was 32.3%. Separated system CVVH is simple, safe, and efficient and could provide cheaper treatments than the integrated system. It could thus be an effective, alternative treatment for critical acute kidney injury patients when the integrated mode is unavailable.

摘要

集成系统连续性静脉-静脉血液滤过(CVVH)是连续性肾脏替代治疗(CRRT)中最常用的模式,需要一台复杂且昂贵的机器,这种机器仅在有限的重症监护病房才有。可简单设置的分离系统CVVH可能是CRRT的一种有效替代方案。对192例急性肾损伤重症患者进行了一项为期一年的关于分离系统CVVH疗效的前瞻性观察研究。所有患者均采用预稀释模式进行分离系统CVVH,平均CVVH剂量为34.9±2.7mL/kg/h。急性生理与慢性健康状况评分系统(APACHEII)评分为23.2±8.4,序贯器官衰竭评估(SOFA)评分为12.0±4.3。未观察到包括空气栓塞或管路凝血在内的并发症,生存率为32.3%。分离系统CVVH简单、安全且高效,与集成系统相比可提供更便宜的治疗。因此,当无法使用集成模式时,它可能是重症急性肾损伤患者的一种有效替代治疗方法。

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