连续性肾脏替代治疗非计划下机影响因素的研究进展

Abstract
Figure/Table
References (35)
Related Citation (15)

Download: PDF (542 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Continuous renal replacement therapy (CRRT) has been widely used in the treatment of critically ill patients. In clinical practice, a variety of factors may lead to substandard treatment times or taking off the machine in advance due to trigger the indications of taking off the machine. This study reviewes the influencing factors of unscheduled taking off the machine of CRRT, it is expected that the result could help medical staffs to recognize the risk factors of the unscheduled taking off the machine, and take some effective measures. Through reviewing of domestic and foreign literatures, combined with the actual clinical situation, it is found that the rate of unscheduled taking off the machine of CRRT is as high as 17.14% to 74.51%, mainly occurring in the first eight hours, and most of them have no direct cause, it is mainly affected with the aspects of patients themselves, vascular access, treatment schemes, and operation staffs, etc.

Key words： Continuous renal replacement therapy Unscheduled taking off the machine Coagulation Influencing factor

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	NIE Anliu SU Xiangfen GUAN Wenjie

Cite this article:

NIE Anliu SU Xiangfen GUAN Wenjie. Research progress on the influencing factors of unscheduled taking off the machine of continuous renal replacement therapy#br#[J]. 中国医药导报, 2022, 19(10): 51-54.

URL:

https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I10/51

[1] Tandukar S，Palevsky PM. Continuous Renal Replacement Therapy：Who，When，Why，and How [J]. Chest，2019，155（3）：626-638.
[2] Rewa OG，Villeneuve PM，Lachance P，et al. Quality indicators of continuous renal replacement therapy（CRRT）care in critically ill patients：a systematic review [J]. Intensive Care Med，2017，43（6）：750-763.
[3] Minet C，Potton L，Bonadona A，et al. Venous thromboembolism in the ICU：main characteristics，diagnosis and thromboprophylaxis [J]. Crit Care，2015，19（1）：287.
[4] 查丽玲，周松，江榕.ICU行枸橼酸抗凝CRRT病人非计划性下机影响因素研究[J].护理研究，2018，32（18）：2926-2930.
[5] 查丽玲，周松，王婧，等.ICU患者持续性肾脏替代治疗非计划性下机相关因素的研究[J].护理学杂志，2017，32（13）：31-34.
[6] Brain MJ，Roodenburg OS，Adams N，et al. Randomized trial of software algorithm driven regional citrate anticoa-gulation versus heparin in continuous renal replacement therapy：the Filter Life in Renal Replacement Therapy pilot trial [J]. Crit Care Resusc，2014，16（2）：131-137.
[7] Brain M，Winson E，Roodenburg O，et al. Non anti-coagulant factors associated with filter life in continuous renal replacement therapy（CRRT）：a systematic review and meta-analysis [J]. BMC Nephrol，2017，18：69.
[8] 陈婷，艾军，莫晓琼，等.106例无肝素连续肾脏替代治疗透析管道凝血时段分析及护理[J].赣南医学院学报，2012，32（6）：938-939.
[9] 邵亚娣.CRRT非计划性下机的原因分析与护理干预[J].护士进修杂志，2012，27（6）：546-548.
[10] 杨惠芳，方振红，蔡晓丹.精细化管理在CRRT非计划性下机中的应用[J].中医药管理杂志，2017，25（17）：116-118.
[11] Zha J，Li C，Cheng G，et al. The efficacy of renal replacement therapy strategies for septic-acute kidney injury：A PRISMA-compliant network meta-analysis [J]. Medicine（Baltimore），2019，98（16）：e15257.
[12] Zhang W，Bai M，Yu Y，et al. Safety and efficacy of regional citrate anticoagulation for continuous renal replacement therapy in liver failure patients：a systematic review and meta-analysis [J]. Crit Care，2019，23（1）：22.
[13] Fu X，Liang X，Song L，et al. Building and validation of a prognostic model for predicting extracorporeal circuit clotting in patients with continuous renal replacement therapy [J]. Int Urol Nephrol，2014，46（4）：801-807.
[14] Fisher R，Lei K，Mitchell MJ，et al. The effect of regional citrate anti-coagulation on the coagulation system in critically ill patients receiving continuous renal replacement therapy for acute kidney injury-an observational cohort study [J]. BMC Nephrol，2017，18（1）：304.
[15] du Cheyron D，Bouchet B，Bruel C，et al. Antithrombin supplementation for anticoagulation during continuous hemofiltration in critically ill patients with septic shock：a case-control study [J]. Crit Care，2006，10（2）：R45.
[16] Parienti JJ，Mégarbane B，Fischer MO，et al. Catheter dysfunction and dialysis performance according to vascular access among 736 critically ill adults requiring renal replacement therapy：a randomized controlled study [J]. Crit Care Med，2010，38（4）：1118-1125.
[17] Mottes T，Owens T，Niedner M，et al. Improving delivery of continuous renal replacement therapy：impact of a simulation-based educational intervention [J]. Pediatr Crit Care Med，2013，14（8）：747-754.
[18] Morgan D，Ho K，Murray C，et al. A randomized trial of catheters of different lengths to achieve right atrium versus superior vena cava placement for continuous renal replacement therapy [J]. Am J Kidney Dis，2012，60（2）：272-279.
[19] Dunn WJ，Sriram S. Filter lifespan in critically ill adults receiving continuous renal replacement therapy：the effect of patient and treatment-related variables [J]. Crit Care Resusc，2014，16（3）：225-231.
[20] 苏勇，史伟，刘双信，等.CRRT中不同类型滤器对血小板数量的影响[J].山东医药，2009，49（13）：104-105.
[21] Westphalen H，Saadati S，Eduok U，et al. Case studies of clinical hemodialysis membranes：influences of membrane morphology and biocompatibility on uremic blood-membrane interactions and inflammatory biomarkers [J]. Sci Rep，2020，10（1）：14808.
[22] Douvris A，Malhi G，Hiremath S，et al. Interventions to prevent hemodynamic instability during renal replacement therapy in critically ill patients：a systematic review [J]. Crit Care，2018，22（1）：41.
[23] Friedrich JO，Wald R，Bagshaw SM，et al. Hemofiltration compared to hemodialysis for acute kidney injury：systematic review and meta-analysis [J]. Crit Care，2012，16（4）：R146.
[24] 刘斌斌，胡才宝.持续性肾脏替代治疗滤器、管路凝血的主要原因分析及干预策略[J].护士进修杂志，2014，（8）：729-731.
[25] Murugan R. Solute and Volume Dosing during Kidney Replacement Therapy in Critically Ill Patients with Acute Kidney Injury [J]. Indian J Crit Care Med，2020，24（Suppl 3）：S107-S111.
[26] 杨德淑，杨平，张艳，等.不同抗凝方案在严重脓毒血症血小板减少患者CRRT中的应用[J].重庆医学，2014， 43（28）：3724-3726.
[27] 张仲华，曾铁英，徐蓉，等.无抗凝连续性肾脏替代治疗非计划性下机相关因素分析[J].护士进修杂志，2019， 34（18）：1633-1639.
[28] 董小伟，张文贤，刘伯英，等.不同抗凝方案对急性肾损伤患者连续性肾脏替代治疗中的应用研究[J].中国临床医生杂志，2018，46（9）：1040-1042.
[29] 关小娟.重症监护病房危重患者床旁连续性肾脏替代治疗的护理干预及实施效果分析[J].中国医药科学，2021， 11（13）：92-94，118.
[30] Harada M，Ooki M，Kohashi K，et al. Clinical Survey of Decreased Blood Flow Rate in Continuous Renal Replacement Therapy：A Retrospective Observational Study [J]. Crit Care Res Pract，2019，29：2842313.
[31] 龚振斌，施云弟，舒海林，等.高容量血液滤过治疗重症感染性休克的效果及对器官功能的改善观察[J].中国当代医药，2021，28（16）：46-49.
[32] Baldwin I，Jones D，Carty P，et al. Continuous Renal Replacement Therapy Without Anticoagulation：Top Ten Tips to Prevent Clotting [J]. Blood Purif，2020，49（4）：490-495.
[33] 彭文芳，张晓迪，罗艺鹏.不同方法预冲透析器及管路对透析患者的临床疗效学评价[J].中国社区医师，2017， 33（17）：30-31.
[34] 魏增玉，涂福泉，吴文伟，等.CVVH联合CRRT对脓毒血症伴急性肾功能衰竭患者肾功能损伤的修复作用[J].疑难病杂志，2021，20（3）：241-245，250.
[35] Mottes TA，Goldstein SL，Basu RK. Process based quality improvement using a continuous renal replacement therapy dashboard [J]. BMC Nephrol，2019，20（1）：17.