Kidney international. Supplement最新文献_第7页

Temporary vascular access for extracorporeal renal replacement therapies in acute renal failure patients. 急性肾衰竭患者体外肾替代治疗的临时血管通路。

Kidney international. Supplement Pub Date : 1998-05-01

B Canaud, H Leray-Moragues, M Leblanc, K Klouche, C Vela, J J Béraud

{"title":"Temporary vascular access for extracorporeal renal replacement therapies in acute renal failure patients.","authors":"B Canaud, H Leray-Moragues, M Leblanc, K Klouche, C Vela, J J Béraud","doi":"","DOIUrl":"","url":null,"abstract":"Temporary vascular access is an essential component to perform any extracorporeal renal replacement therapy (RRT) in the acute renal failure patient. RRT used in the acute setting may be categorized in two groups: intermittent (IRRT) and continuous (CRRT). Therapeutic indications are based on clinical and technical considerations. Continuous modalities are mainly utilized in intensive care units for hemodynamically compromised patient. Initially performed spontaneously via an arteriovenous circuit, CRRT modalities have progressively become venovenous with the circulatory assistance of a blood pump. Since both intermittent and continuous RRT modalities are now performed almost exclusively by venovenous modalities, this article deals exclusively with temporary venous catheters. At present, double-lumen catheters represent the most common vascular access for RRT modalities. Semi-rigid polyurethane catheters currently used in case of emergency are limited to short term use. Hemocompatible, flexible silicone catheters, less aggressive for the vessels, seem better suited for the medium and long term run. The tunneled silicone catheters (DualCath type) meet the short and long term needs, and allow for blood flow rates up to 400 ml/min. The internal jugular vein, particularly the right one, seems to warrant the proper functioning of catheters while reducing the risk of stenotic complications. Subclavian access should be limited in time and reserved for silicone catheters in order to limit the risk of stenosis and/or thrombosis. Femoral access, very useful in cases of emergency and respiratory problems, greatly impairs the patient's mobility and should be limited by time to prevent thrombosis and/or infection. Late and/or delayed dysfunctioning of catheters are indicative of a thrombosis. Performance standards of catheters are less of a limiting factor in continuous low flow RRT modalities than in the intermittent ones. Finally, careful handling of the catheter essential to prevent infectious complications.","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"66 ","pages":"S142-50"},"PeriodicalIF":0.0,"publicationDate":"1998-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20495040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous renal replacement therapy: evolution in technology and current nomenclature. 持续肾替代疗法:技术的演变和目前的命名。

Kidney international. Supplement Pub Date : 1998-05-01

C Ronco, R Bellomo

引用次数: 0

The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group. 重症监护病房急性肾衰竭的频谱与其他设置的比较。马德里急性肾衰竭研究组。

Kidney international. Supplement Pub Date : 1998-05-01

F Liaño, E Junco, J Pascual, R Madero, E Verde

{"title":"The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group.","authors":"F Liaño, E Junco, J Pascual, R Madero, E Verde","doi":"","DOIUrl":"","url":null,"abstract":"Acute renal failure (ARF) is at a crossroads between nephrology and intensive care medicine. However, there seems to be wide differences between the ARF observed in the intensive care unit (ICU) compared to that observed in other areas of the hospital, particularly when examining the mortality rate. Among the ICU patients the 70% mortality rate is higher to the 50% found in an overall series of studies. Recently, Druml proposed that there is a changing trend in the clinical spectrum of ARF as a convincing reason to justify these differences. According to him, we are moving from an ARF seen as a mono-organ failure to another one observed in a multiorgan dysfunction syndrome (MODS) context. Although extremely coherent, this hypothesis has not been fully confirmed in a prospective study. In fact, most authors seem to look at the problem from opposite sides of the river, either from the critical medicine or the nephrological bank. To the best of our knowledge, only one retrospective study has dealt with this topic by comparing outcome of ARF in ICU and non-ICU patients. In this article we aim to overcome this problem by reviewing the data of the prospective epidemiological ARF study carried out in Madrid using two different approaches: (1) comparing the ARF cases observed in the ICU setting with those ARF studied outside the ICU, and (2) comparing the outcome of isolated ARF with the outcome of ARF as part of a MODS in patients treated in both settings.","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"66 ","pages":"S16-24"},"PeriodicalIF":0.0,"publicationDate":"1998-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20500637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antibiotic therapy and microbiologic considerations in the intensive care unit. 重症监护病房的抗生素治疗和微生物学考虑。

Kidney international. Supplement Pub Date : 1998-05-01

F de Lalla

引用次数: 0

Coagulation disorders in acute renal failure. 急性肾衰竭中的凝血功能障碍。

Kidney international. Supplement Pub Date : 1998-05-01

M R Schetz

引用次数: 0

Acid-base balance and replacement solutions in continuous renal replacement therapies. 持续肾替代疗法的酸碱平衡和替代方案。

Kidney international. Supplement Pub Date : 1998-05-01

M Feriani, R Dell'Aquila