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无水处理的长期间歇性脏替代疗法:在ICU环境中进行脏替代疗法的新方法. 一个回顾性研究研究
Noémie Zucman1, Fabrice Uhel2, Charles Verney1
1AP-HP, Hôpital Louis Mourier, DMU ESPRIT, Service de Médecine Intensive Réanimation, F-92700 Colombes, France; Université Paris Cité, Medical school, F-75018 Paris, France.
Journal of critical care
|January 12, 2025
概括
一种新的置换疗法 (KRT) 技术,即无水处理的长期间歇性KRT (WTF-PIKRT),在水处理系统无法使用时提供了替代方案. 这种方法可以有效地去除溶液,而不需要专门的基础设施.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 密集护理医学 密集护理医学
背景情况:
- 在ICU中进行最佳置换疗法 (KRT) 正在讨论中,间歇性血液透析 (IHD) 和持续静脉静脉透析 (CVVH) 是主要的方法.
- IHD需要水处理系统,在某些地区限制其使用.
研究的目的:
- 评估一种创新的间歇式KRT策略,可以绕过对水处理系统的需求.
- 评估"无水处理的长期间歇性置换疗法" (WTF-PIKRT) 的可行性和结果.
主要方法:
- 通过并行连接增加透析液流量,修改了CVVHDF后稀释模式.
- 在18名患者中实施WTF-PIKRT,在2019年8月至2020年5月期间进行88次会议 (中位数为5小时).
- 使用的血液流速为250毫升/分钟,透析液流量为9000毫升/小时.
主要成果:
- 达到38%的中位数尿素减少比.
- 低血压发生在21.6%的会议中.
- 低血或低血的发生率低于5%.
结论:
- 在没有水处理系统的情况下,WTF-PIKRT是传统IHD的可行的替代方案.
- 虽然WTF-PIKRT效率低于IHD,但提供了显著的组织和经济优势.
- 这种技术在资源有限的环境中扩大了KRT的可访问性.
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