在连续脏替代疗法期间,血红素监测和血液体积估计
Ian Baldwin1, Akinori Maeda2, Rinaldo Bellomo3
1Department of Intensive Care, Austin Hospital, Melbourne, Australia.
概括
在连续脏替代疗法 (CRRT) 期间,现在可以持续监测血红素 (Hct) 和血液体积变化 (ΔBV%). 这种技术修改允许改善流体管理和检测CRRT患者显著的血液体积变化.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 生物医学工程 生物医学工程
背景情况:
- 持续置换疗法 (CRRT) 缺乏对血红蛋白,氧和和血红素 (Hct) 的综合监测.
- 目前的CRRT机器不包含Hct监测,这种监测可用于间歇性血液透析,可以估计血液体积变化 (ΔBV%).
- 在CRRT患者中优化流体管理受到缺乏连续Hct和ΔBV%监测的阻碍.
研究的目的:
- 描述一项技术修改,使得在CRRT过程中能够持续监测Hct和ΔBV%.
- 为了证明将独立显示器和自定义适配器集成到CRRT电路中的可行性.
- 评估该技术在实时流体管理和检测血液体积转移方面的潜力.
主要方法:
- 使用了一个独立的监视器 (CRIT-LINE®IV) 和一个带有定制设计的适配器的线性血液室.
- 在CRRT电路的血管通道输出处集成监控系统.
- 记录了超过12小时的CRRT估计的Hct和衍生 ΔBV% 数据,以及其他生理参数.
主要成果:
- 在CRRT期间成功实施连续Hct和ΔBV%监测.
- 观察到每小时的患者净流体损失范围在0-308毫升/小时之间.
- 在CRRT期间检测到未检测到的大约15%的血液体积减少,突出显示了该技术的诊断能力.
结论:
- 开发了CRRT电路的技术修改,以使以前无法使用的流体转移评估成为可能.
- 这一进步有助于在CRRT期间持续监测血红素和血液体积变化.
- 描述的技术为进一步的临床试验提供了可能性,以优化CRRT流体管理.
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