Division of Critical Care Medicine, Department of Anesthesiology, University of Maryland Medical School, Baltimore, MD; Division of Trauma Anesthesiology, Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland Medical School, Baltimore, MD.
J Crit Care. 2013 Dec;28(6):1019-26. doi: 10.1016/j.jcrc.2013.05.018. Epub 2013 Jul 24.
Familiarity with the initiation, dosing, adjustment, and termination of continuous renal replacement therapy (CRRT) is a core skill for contemporary intensivists. Guidelines for how to administer CRRT in the intensive care unit are not well documented. The purpose of this review is to discuss the modalities, terminology, and components of CRRT, with an emphasis on the practical aspects of dosing, adjustments, and termination. Management of electrolyte and acid-base derangements commonly encountered with acute renal failure is emphasized. Knowledge regarding the practical aspects of managing CRRT in the intensive care unit is a prerequisite for achieving desired physiological end points.
熟悉连续性肾脏替代治疗(CRRT)的启动、剂量调整、终止是当代重症医师的核心技能。关于如何在重症监护病房中进行 CRRT 的指南没有很好的记录。本文的目的是讨论 CRRT 的方式、术语和组成部分,重点是剂量调整和终止的实际方面。强调了急性肾衰竭常见的电解质和酸碱失衡的管理。了解重症监护病房中 CRRT 的实际管理方面是实现理想生理终点的前提。