Download
1 / 80
820 likes | 1.11k Views
Aspetti clinici della CRRT: indicazione, timing, anticoagulazione ed antibiotici. Andrea De Gasperi 2° SAR e Trapianti addominali Ospedale Niguarda - Ca Granda Milano. Criteria for Initiation of RRT. The “RIFLE - SCORE” Approach. RISK. INJURY. Prophylactic CRRT. FAILURE.
E N D
Aspetti clinici della CRRT: indicazione, timing, anticoagulazione ed antibiotici Andrea De Gasperi 2° SAR e Trapianti addominali Ospedale Niguarda - Ca Granda Milano CRRT - SMART 2008
Criteria for Initiation of RRT The “RIFLE - SCORE” Approach RISK INJURY Prophylactic CRRT FAILURE Recovery Phase Very early CRRT ESRD LOSS Late CRRT Mortality (Picard Study) Diuretics CRRT - SMART 2008
Criteria for Initiation of RRT Outcome in Post-Trauma ARF (late vs early)/Gettings Study 100 Patients – CRRT started after Multiple Trauma P < 0,041 CRRT - SMART 2008
Timing and indications CRRT - SMART 2008
Dialysis dose CRRT - SMART 2008
Dialysate composition CRRT - SMART 2008
Factors able to affect filter life CRRT - SMART 2008
the ideal anticoagulant for CRRT prevent filter clotting without inducing haemorrhage short half-life action limited to the extracorporeal circuit reduced / absent systemic side effects antagonist available monitoring easy bedside CRRT - SMART 2008
Heparin anticoagulation is the most commonly used method to prevent clotting in CRRT Often the sole anticoagulant in continuous venovenous hemofiltration aPTT or ACT to monitor heparin effect. CRRT - SMART 2008
CLCRRT of antimicrobial • agents during the application of CVVH and CVVHDF • basis for the optimal dosage adjustments of different antimicrobial agents. CRRT - SMART 2008
