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| The influences of flush methods during daytime continuous renal replacement therapy without anticoagulation on machine pressures |
| GUO Hongjing1 LI Li2 XIANG Jing3 HUANG Jing3 GENG Hebing1 WANG Yan4 ZHU Xiuqin1 WANG Jianrong4▲ |
1.Clinical Department of Internal Medicine, PLA General Hospital, Beijing 100853, China;
2.Clinical Department, South Building, PLA General Hospital, Beijing 100853, China;
3.Clinical Department of Nephrology, PLA General Hospital, Beijing 100853, China;
4.Nursing Department, PLA General Hospital, Beijing 100853, China |
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Abstract Objective To explore the saline flushes and non-saline flush's influence on the machines' pressure values when renal replacement therapy (CRRT) was imposed on the critical patients with high risk of bleeding. Methods 43 patients who were in the general hospital of Clinical Department of Nephrology, PLA General Hospital from May 2014 to February 2015 with high risk of bleeding acute or chronic renal failure undergoing CRRT without anticoagulation were selected and divided into saline flush group (21 cases) and non-saline flush group (22 cases) according to whether saline flushing pipeline was adopted. To observe The TMP, PBE and filter pressure decrease value (ΔP) changes of the two groups were observed when they were in therapy at 6 points in time, which was from the start of CRRT (T0), after 1 h (T1)，2 h (T2), 3 h (T3), and 4 h (T4) of CRRT, and at the end (T5) of CRRT. Results In non-saline flush group, TMP was greater on T3, T4, T5 (P < 0.01) than T0, and was greater on T5 than T1 (P < 0.01). In saline flushes group, TMP was greater on T4, T5 than T0 and T1 (P < 0.05). The change of PBE in non-saline flush group was significantly greater on T1, T2, T3, T5 than in saline flushes group (P < 0.05). Compared with non-flush group at T0, ΔP were increased at T1, T2, T3, T4 (P < 0.05), ΔP was significantly greater at T5 than T1 (P < 0.01). At T5, the ΔP change value was greater in non-saline flush group than saline flush group (P < 0.05). Due to the high pressure limits, two group patients' therapy machine were all alarmed and stopped after 5 hours of CRRT, which including 1 case of saline flush (4.76%), 4 cases of non-saline flush (18.18%), the difference has the statistical significance (P < 0.05). Conclusion Saline flushes can restrain the increase of the pressure on the machine. It makes sense for the prevention of blood coagulation of extracorporeal circulation after 5 h of CRRT.
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