【持续性肾脏替代治疗crrt英文精品课件】current technology for crrt

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1、CurrentTechnologyforCRRTDr.PeterSkippen,PICU.BCChildren’sHospital,Vancouver.CANADA.OutlineTheidealCRRTmachineHardwareoptionsHomemadeDedicatedfullyintegratedConclusionsTheIdealMachineforCRRT:IInexpensive/userfriendly/flexibleAccurate/dedicatedpumpsAccuratescalesBloodflows5-300mls/mini

2、ncrementsof1ml/minContinuousindependentflowmeasurementsServocontrolledThermoregulationFullrangeofsafetyfeaturesTheIdealMachineforCRRT:IISafetyfeaturesAudible/visualalarmswithover-rideAir/clotdetectorsBloodleakdetectorsContinuousdisplayofcircuitpressuresContinuousUfureaconcentrationCo

3、ntinuouscircuitHctMinimalalarms-maximumpatientsafetyTheIdealCircuitforCRRTMinimalprimingvolume/lowresistanceEasypriming/recirculationprocedureExchangeablecomponentsBiocompatibleNoninflammatoryHemodynamicstabilityNonthrombogenicIntegratedHardwareOptionsHomemadedevicesDedicated“allinon

4、e”machineEdwardsM25PRISMABraunDIAPACTFresenius2integratedmodulesBloodmodule(BM11)Balancingmodule/scales(BM14)EdwardsBM25EdwardsBM25:BloodPumpModuleBloodmonitorpediatricflows:5-150mls/minIncrementsof1mlEdwardsBM25:Effluent/ReplacementPumpModuleBalancingmonitorSubstitutionpump/filtrate

5、pumpIntegratedscales:claimedaccuracy1%(20mlsin2000mls)ReplacementfluidheaterTMPmonitorOperationalrangesReplacementfluid100-9000mls/hr(100mlincrements)Filtratepump100-11,000mls/hrNetUFR0.1-2000mls/hrEdwardsBM25:AdvantagesRelativelylowercostSimplicityEasyprimingFlexibilitySeparatearter

6、ial/venoustubingUseanyfilterNeonatetoadultAnytreatmentoptionwithmodificationWithlossofsimplicityReplacementfluidwarmerEdwardsBM25:DisadvantagesOnly3pumpsForCVVHDF,extrapumpcreatesproblemsDoesnotcalculateFFNoscreenTroubleshootingrequirestraining!Blood/airinterfacewithbubbletrap?PRISMA

7、CRRTMachineTouchscreenCompleterangeoftherapies3weighingscalesaccuracy<+/-0.5%Customfilter/circuitryPRISMACRRTMachine:BasicLayoutReplacementDialysateEffluentBloodHeparinSyringePumpPressurePodsScalesx3PRISMAScreenPRISMAScreenUserfriendlyinterfaceStepbystepinstructionsContinuousdisplayo

8、ftreatmentco