Acute Continuous Renal Replacement Therapy
Emil P. Paganini
Springer Science & Business Media, Mar 31, 1986 - Medical - 292 pages
The initial observations of dialytic support were brought from the laboratory and confined to patients with reversible acute renal failure. The thought at that time was one of short term maintenance. It was theorized that removal of waste products from the blood, albeit incomplete and inefficient, might allow these patients time to regenerate damaged tubules and regain renal function. After a dis appointing earlier experience in survival, greater sophisti cation and broader practice refined the dialysis skills and reduced mortality. It also became apparent that long periods of support were possible and successful attempts were then made in utilizing this technology in patients with chronic renal failure. These early young patients were a very select group who possessed only renal dysfunction and no other systemic involvement. Nonetheless, they demonstrated a one year survival of only 55-64%. There are presently over 80,000 patients on dialytic support in the United States and over 250,000 patients worldwide dependent on artificial replace ment. Mortality statistics vary but despite a 20-30% systemic disease involvement and a fifth decade average age in the North American experience, the one year survival has risen to apparently 90%.
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acute renal failure Amicon amino acids Ann Intern arterial and venous arterial line arteriovenous hemofiltration CAVH Artif Intern Organs azotemia blood flow blood lines blood pressure calculated cannulation catheter CAVHD clinical clotting continuous arteriovenous hemofiltration creatinine critically ill patient decrease dilution electrolyte filter filtrate output filtration rate fluid balance fluid removal glucose hematocrit hemo hemodialysis hemodynamic Henderson LW heparin heparin infusion increase infusion pump Kaplan AA Kidney Kramer levels LWCT mean arterial pressure membrane metabolic mL/hr mL/min mmHg monitoring nursing oncotic pressure patients with acute peritoneal dialysis plasma plasma water postdilution predilution mode procedure protein concentration renal replacement therapy replacement fluid replacement solution Scribner shunt SCUF or CAVH serum shunt sieving coefficient slow continuous ultrafiltration Soc Artif Intern solute removal substitution fluid suction suction-assist Table technique tion Trans Am Soc transmembrane pressure tration tubing ultrafil ultrafiltration rate urea clearance vascular access volume