Ender L A, Vatazin A V, Fomin A M, Machulina N Iu
Anesteziol Reanimatol. 1993 May-Jun(3):43-6.
The studies conducted in 27 patients with disseminated suppurative peritonitis and multiorgan failure made it possible to optimize the basic technical parameters of hemofiltration. It has been shown that the volume of replacement of 20-25 1 with postdilution is the optimal. To prevent hemodynamic reactions during hemofiltration, hemodynamic monitoring using impedance plethysmography should be conducted and the speed of the procedure should be changed with the appearance of preclinical signs of chill. When there is no vascular response and blood cortisol level is not increased, the adrenal cortex function depletion should be considered and hormones should be preventively administered.
对27例弥漫性化脓性腹膜炎合并多器官功能衰竭患者进行的研究,使得优化血液滤过的基本技术参数成为可能。结果表明,后稀释时置换量为20 - 25升是最佳的。为预防血液滤过期间的血流动力学反应,应使用阻抗体积描记法进行血流动力学监测,并在出现寒战临床前体征时改变操作速度。当无血管反应且血皮质醇水平未升高时,应考虑肾上腺皮质功能耗竭,并预防性给予激素。