Priming dan Troubleshooting CRRT Edward Aquarius
•Download as PPS, PDF•
0 likes•4,285 views
Bagaimana cara mempersiapkan CRRT Edward Aquarius sehingga dapat segera difungsikan. Disertai dengan Trobleshooting.
Report
Share
Report
Share
Recommended
CRRT
[Ringkasan]
Continuos Renal Replacement Terapi (CRRT) merupakan terapi pengganti ginjal secara terus menerus selama 24 jam untuk mengeluarkan cairan dan solute menggunakan ekstrakorporal. CRRT dilakukan pada pasien hemodinamik tidak stabil maupun stabil untuk mengeluarkan zat yang tidak terpakai, mengatur keseimbangan asam basa dan elektrolit, serta menstabilkan hemodinamik dan keseimbangan cairan.
3 prismaflex basic setup operation
The document provides information about setting up and using the Prismaflex dialysis machine. It discusses:
1) The basic setup which includes priming the lines, loading the correct filter set, and ensuring proper connections before starting treatment.
2) How to start treatment including calculating fluid removal rates and setting blood, replacement fluid, and effluent pump flows.
3) An overview of treatment management which involves monitoring pressures, alarms, fluid balances and treatment parameters.
4) Common alarms involving the blood leak detector, air detectors, and pressure issues; and how to address them.
1 prismaflex crrt intro - seg 1 (2007)
The document outlines the objectives and key concepts of a training course on continuous renal replacement therapy (CRRT). It defines CRRT and discusses the basic principles of CRRT, including solute transport mechanisms, clinical indications, machine setup and safety features, and fluid balance principles. It also summarizes evidenced-based research showing improved patient survival with early CRRT initiation and adequate dose delivery.
IABP
IABP adalah alat bantu mekanik yang digunakan untuk menurunkan kebutuhan oksigen jantung dan meningkatkan output jantung dengan cara mengembangkan balon di dalam aorta pada fase diastole dan mengembuskannya pada awal sistole. IABP dapat meningkatkan aliran darah selama diastole dan mengurangi beban kerja jantung selama sistole. IABP memiliki berbagai indikasi penggunaan seperti syok kardiogenik dan sind
Crrt dr osama elshahat 2017
This document discusses various aspects of renal replacement therapy for acute kidney injury. It begins by outlining the stage-based management of AKI, with increasing intervention and monitoring recommended as the stage progresses from risk to injury to failure. The document then addresses indications for starting renal replacement therapy, appropriate modalities including intermittent hemodialysis, slow continuous ultrafiltration, and continuous renal replacement therapy. Key factors like vascular access, solutions, membranes, anticoagulation, and dose are discussed. The overall conclusions are that while data from high-quality randomized controlled trials are still lacking, earlier initiation of renal replacement therapy may aid recovery, and continuous modalities are generally preferred over intermittent hemodialysis for unstable patients. Individualization of
Kamc crrt training
CRRT describes a group of renal replacement therapies that provide continuous renal replacement over an extended period of time, typically 24 hours per day. There are several CRRT modalities including CVVH, CVVHD, and CVVHDF that utilize different molecular transport mechanisms like diffusion, convection, and ultrafiltration. CRRT is commonly used to treat acute kidney injury as it closely mimics the native kidney and is better tolerated by hemodynamically unstable patients. Studies have shown that earlier initiation of CRRT and achieving an adequate dose of effluent flow rate or solute clearance may improve survival rates in patients with acute renal failure.
Dr alaa saleh complications of peritoneal dialysis (2)
Peritoneal dialysis complications include:
1) Catheter related issues such as pain, poor flow, and cuff erosion.
2) Hernias which occur in 10-20% of patients and are minimized by proper catheter placement.
3) Dialysate leaks which can occur through the exit site or cause hydrothorax and are related to catheter placement.
4) Metabolic complications from glucose absorption which can cause weight gain, hypertriglyceridemia, and loss of amino acids in the effluent dialysate.
CRRT basic principal by Wael Nasri
Continuous renal replacement therapy (CRRT) involves using extracorporeal blood purification therapies to slowly remove waste and fluid from patients with impaired kidney function over an extended period of time, typically 24 hours per day. CRRT aims to closely mimic the native kidney and is well-tolerated by hemodynamically unstable patients. It allows for gentle removal of large amounts of fluid and waste products while also controlling electrolytes, acid-base balance, and removal of sepsis mediators. CRRT has advantages over intermittent dialysis in managing fluid overload and maintaining hemodynamic stability.
Recommended
CRRT
[Ringkasan]
Continuos Renal Replacement Terapi (CRRT) merupakan terapi pengganti ginjal secara terus menerus selama 24 jam untuk mengeluarkan cairan dan solute menggunakan ekstrakorporal. CRRT dilakukan pada pasien hemodinamik tidak stabil maupun stabil untuk mengeluarkan zat yang tidak terpakai, mengatur keseimbangan asam basa dan elektrolit, serta menstabilkan hemodinamik dan keseimbangan cairan.
3 prismaflex basic setup operation
The document provides information about setting up and using the Prismaflex dialysis machine. It discusses:
1) The basic setup which includes priming the lines, loading the correct filter set, and ensuring proper connections before starting treatment.
2) How to start treatment including calculating fluid removal rates and setting blood, replacement fluid, and effluent pump flows.
3) An overview of treatment management which involves monitoring pressures, alarms, fluid balances and treatment parameters.
4) Common alarms involving the blood leak detector, air detectors, and pressure issues; and how to address them.
1 prismaflex crrt intro - seg 1 (2007)
The document outlines the objectives and key concepts of a training course on continuous renal replacement therapy (CRRT). It defines CRRT and discusses the basic principles of CRRT, including solute transport mechanisms, clinical indications, machine setup and safety features, and fluid balance principles. It also summarizes evidenced-based research showing improved patient survival with early CRRT initiation and adequate dose delivery.
IABP
IABP adalah alat bantu mekanik yang digunakan untuk menurunkan kebutuhan oksigen jantung dan meningkatkan output jantung dengan cara mengembangkan balon di dalam aorta pada fase diastole dan mengembuskannya pada awal sistole. IABP dapat meningkatkan aliran darah selama diastole dan mengurangi beban kerja jantung selama sistole. IABP memiliki berbagai indikasi penggunaan seperti syok kardiogenik dan sind
Crrt dr osama elshahat 2017
This document discusses various aspects of renal replacement therapy for acute kidney injury. It begins by outlining the stage-based management of AKI, with increasing intervention and monitoring recommended as the stage progresses from risk to injury to failure. The document then addresses indications for starting renal replacement therapy, appropriate modalities including intermittent hemodialysis, slow continuous ultrafiltration, and continuous renal replacement therapy. Key factors like vascular access, solutions, membranes, anticoagulation, and dose are discussed. The overall conclusions are that while data from high-quality randomized controlled trials are still lacking, earlier initiation of renal replacement therapy may aid recovery, and continuous modalities are generally preferred over intermittent hemodialysis for unstable patients. Individualization of
Kamc crrt training
CRRT describes a group of renal replacement therapies that provide continuous renal replacement over an extended period of time, typically 24 hours per day. There are several CRRT modalities including CVVH, CVVHD, and CVVHDF that utilize different molecular transport mechanisms like diffusion, convection, and ultrafiltration. CRRT is commonly used to treat acute kidney injury as it closely mimics the native kidney and is better tolerated by hemodynamically unstable patients. Studies have shown that earlier initiation of CRRT and achieving an adequate dose of effluent flow rate or solute clearance may improve survival rates in patients with acute renal failure.
Dr alaa saleh complications of peritoneal dialysis (2)
Peritoneal dialysis complications include:
1) Catheter related issues such as pain, poor flow, and cuff erosion.
2) Hernias which occur in 10-20% of patients and are minimized by proper catheter placement.
3) Dialysate leaks which can occur through the exit site or cause hydrothorax and are related to catheter placement.
4) Metabolic complications from glucose absorption which can cause weight gain, hypertriglyceridemia, and loss of amino acids in the effluent dialysate.
CRRT basic principal by Wael Nasri
Continuous renal replacement therapy (CRRT) involves using extracorporeal blood purification therapies to slowly remove waste and fluid from patients with impaired kidney function over an extended period of time, typically 24 hours per day. CRRT aims to closely mimic the native kidney and is well-tolerated by hemodynamically unstable patients. It allows for gentle removal of large amounts of fluid and waste products while also controlling electrolytes, acid-base balance, and removal of sepsis mediators. CRRT has advantages over intermittent dialysis in managing fluid overload and maintaining hemodynamic stability.
anticoagulation CRRT .pptx
This document discusses anticoagulation for continuous renal replacement therapy (CRRT). It begins by outlining factors that can lead to clotting of CRRT filters and circuits. The main anticoagulation modalities discussed are heparin, low molecular weight heparin, citrate, and no anticoagulation. For each option, the mechanisms of action, advantages, disadvantages, dosing protocols, and typical filter life spans are summarized. Regional citrate anticoagulation is highlighted as it avoids systemic anticoagulation effects while effectively preventing clotting. Details are provided on citrate metabolism and calcium replacement to maintain safe ionized calcium levels.
Renal replacement therapy
This document summarizes renal replacement therapy modalities. It discusses that acute kidney injury affects 5% of hospitalized patients and increases mortality. The main renal replacement therapies are hemodialysis, peritoneal dialysis, and continuous renal replacement therapies. Hemodialysis removes water and solutes across a semipermeable membrane via diffusion and convection. Peritoneal dialysis utilizes the peritoneal membrane for solute and fluid removal. Choice of modality depends on patient factors and available resources. The goal of renal replacement therapy is to control fluid, electrolyte, and acid-base disturbances while providing adequate solute clearance.
2 prismaflex crrt basic components - seg 2
The document discusses the basic components of continuous renal replacement therapy (CRRT), including hemofilters, solutions, vascular access points, anticoagulation methods, and blood warmers. It provides details on the PrismaFlex CRRT system, including its disposable set, solutions, and flow control and fluid control units. The flow control unit contains pumps, pinch valves, and a patented deaeration chamber for air removal. The fluid control unit uses several scales to measure effluent, replacement, dialysate, and pre-blood pump fluids.
Advanced hemodynamic monitoring
This document discusses less invasive methods of advanced hemodynamic monitoring. It begins by explaining the key factors that affect hemodynamic conditions like cardiac output, including heart rate, intravascular volume, myocardial contraction, and vasoactivity. It then discusses several noninvasive and invasive monitoring methods and focuses on pulse wave contour analysis and transpulmonary thermodilution techniques. These techniques can provide continuous cardiac output measurements along with volumetric parameters through advanced analysis of arterial pressure waveforms and thermal dilution curves. The document concludes by outlining typical values of parameters measured and providing an example decision tree for fluid and drug therapy guided by hemodynamic monitoring.
Water copy
This document discusses water treatment for hemodialysis units. It notes that water quality significantly impacts patient outcomes. The summary is as follows:
1. Proper water treatment is essential for hemodialysis patients who are exposed to large volumes of water each week through dialysis.
2. The water treatment system uses various processes like carbon filtration, softening, reverse osmosis, and deionization to remove contaminants.
3. Strict policies, documentation, and staff education are needed to ensure the water treatment system operates safely and provides water that meets quality standards.
Perawatan Monitoring CVP dan Swans Ganz
Perawatan dan indentifikasi masalah seputar perawatan CVP dan Swans Ganz. Bukan hanya pada troubleshooting alatnya saj. Namun juga pada tindakan keseharian kita dalam menggunakan monitoring hemodinamik.
Monitoring Cvp
CVP digunakan untuk memantau tekanan vena sentral dan fungsi ventrikel kanan. Nilai normal CVP adalah 3-8 mmHg. Komplikasi yang dapat terjadi meliputi emboli udara, pneumotoraks, dan infeksi, namun dapat dicegah dengan teknik steril dan memantau tanda infeksi.
Fluid Fluid Overload: Poor Cosmetics or Bad Medicine
The document discusses the risks of fluid overload in critically ill patients and strategies for de-resuscitation. It summarizes evidence that a conservative fluid strategy after day 3 of critical care that aims for fluid balance equilibrium or negativity is associated with improved patient outcomes compared to more liberal fluid management. The key message is that fluid overload is an independent predictor of poor outcome, so the reasons for de-resuscitation are to avoid the pathophysiological effects of fluid overload.
Renal replacement therapy
- Renal replacement therapies are important in critical care for managing complications of renal failure such as fluid, electrolyte and acid-base imbalances. There are many questions around optimal therapy including timing, dose and modality.
- Acute kidney injury is common in the ICU and associated with worse outcomes. Continuous renal replacement therapies may provide more stable volume and chemistry control compared to intermittent therapies.
- High volume hemofiltration shows promise for removing inflammatory mediators in sepsis but optimal dose is still unclear. Renal replacement therapies have an important role beyond renal support as blood purification techniques.
Ventilasi mekanik
Ventilator adalah alat bantu pernapasan yang membantu proses ventilasi untuk menjaga oksigenasi tubuh. Ventilator dapat membantu pasien dengan gagal napas akibat berbagai penyebab seperti cedera kepala, infeksi otak, kelainan otot pernapasan, dan kelainan paru dan jantung. Pemberian ventilator harus sesuai dengan kondisi pasien dan diatur berdasarkan hasil analisis gas darah untuk mencegah komplikasi seperti gang
TEMPORARY PACE MAKER
TPM digunakan untuk mengobati gangguan sistem konduksi jantung sementara. TPM bekerja dengan memberikan impuls listrik ke jantung untuk menjaga irama kontraksi yang normal. Ada beberapa jalur pemasangan elektrode TPM, dan komponen utamanya adalah generator, kabel, dan elektrode. Pemasangan TPM harus dilakukan dengan hati-hati untuk mencegah komplikasi seperti infeksi atau pergeseran elektrode.
14 Konsep Dasar EKG
Dokumen tersebut memberikan ringkasan singkat tentang sistem konduksi jantung dan elektrokardiografi. Sistem konduksi jantung terdiri dari beberapa sel pacemaker yang mengeluarkan impuls untuk menciptakan depolarisasi dan repolarisasi. Elektrokardiografi merekam aktivitas listrik jantung untuk tujuan diagnostik gangguan jantung. Terdapat beberapa gelombang dan interval khas pada elektrokardiogram normal.
The four phases of intravenous fluid therapy: Manu Malbrain
This document discusses fluid management in intensive care patients. It notes that fluids are drugs that require appropriate dosing, timing, and de-escalation. Inappropriate fluid therapy can lead to hyperchloremic metabolic acidosis, acute kidney injury, and increased mortality. The key factors in empiric fluid therapy are considering patient risk factors for fluid overload and targeting fluids specifically for resuscitation, maintenance, or replacement needs rather than focusing solely on hemodynamic parameters. Fluid removal should begin when shock is resolved to avoid complications from fluid overload.
Crrt sudan 2017 dr. osama el shahat
Stage-based management of acute kidney injury (AKI) involves monitoring for progression from risk to injury to failure. For stage 1 (risk), monitoring to prevent progression is recommended. For stage 2 (injury), conservative therapy is recommended due to high risk of mortality/morbidity. For stage 3 (failure), renal replacement therapy (RRT) should be considered due to highest risk of death. Continuous renal replacement therapy (CRRT) is preferred for hemodynamically unstable patients and allows for slow correction while maintaining hemodynamic stability. Higher CRRT doses of 35 ml/kg/hr may improve survival compared to lower doses, though optimal dosing remains controversial.
Which cardiac output monitoring?
1) The document discusses choosing cardiac output monitoring devices for peri-operative and ICU settings. It considers devices' reliability with changing vascular resistance and ability to provide useful clinical information.
2) For peri-operative monitoring of high-risk surgical patients, less invasive devices using uncalibrated pulse contour analysis like Vigileo and Clearsight may be suitable when vascular resistance does not change significantly.
3) For ICU patients receiving vasopressors where resistance changes greatly, more reliable thermodilution methods like PiCCO, EV1000 and pulmonary artery catheter are recommended to measure cardiac output and assess ventricular function.
Dexmedetomidine in icu hashemian
Dexmedetomidine is a selective alpha-2 adrenergic receptor agonist used for sedation in the ICU. It provides "cooperative sedation" allowing easy patient awakening and assessment. Studies show dexmedetomidine reduces delirium and time on ventilators compared to midazolam and propofol. The most common side effects are hypotension and bradycardia. Dexmedetomidine has potential benefits for treating agitation, delirium, alcohol withdrawal syndrome, and may reduce opioid needs and cardiovascular risks in ICU patients.
less invasive hemodynamic monitoring
less invasive hemodynamic monitoringDepartment of Anesthesiology, Faculty of Medicine Hasanuddin University
Pendahuluan:
Tissue disoxia merupakan problema utama dari pasien2 baik pascabedah maupun pasien sakit kritis di ICU
Tissue disoxia dapat disebabkan oleh rendahnya DO2, gangguan mikrosirkulasi dan peningkatan kebutuhan metabolisme sistim selular
Berlanjut menjadi cytopathic hypoxia yang disebabkan oleh disfungsi mitokhondriaMode of ventilation
This document discusses respiratory failure and various modes of mechanical ventilation. It begins by distinguishing between respiratory failure and respiratory insufficiency. It then covers initiating mechanical ventilation using either volume ventilation or pressure ventilation. Various modes are discussed including volume-targeted modes like control, assist, SIMV+PS. Pressure-targeted modes like pressure control ventilation and PSV are also covered. The document discusses the challenges of ventilating ARDS patients and how newer dual modes and closed-loop modes can help minimize ventilator-induced lung injury while maintaining lung recruitment and pressures. It also introduces APRV and bi-level ventilation as newer modes to apply PEEP above the lower inflection point.
Prisma™ Priming And Troubleshooting
The document provides instructions for priming and troubleshooting the Prisma continuous renal replacement therapy (CRRT) machine. It describes how to power on the machine, calibrate the scales, select a patient and therapy, prime the tubing set, program therapy settings, connect the machine to the patient, and end a treatment. It also gives guidance on resolving common issues like pressure alarms, scale resets, fluid removal errors, and air in lines.
CRRT
CRRT (continuous renal replacement therapy) involves using an extracorporeal circuit connected to the patient via catheters to slowly remove fluid and toxins over 24 hours, mimicking the function of the kidneys. It was developed for critically ill patients who cannot tolerate the fluid shifts of intermittent hemodialysis. CRRT uses a semipermeable membrane to filter fluids and small molecules from the blood based on hydrostatic pressure gradients. It provides more hemodynamic stability than intermittent hemodialysis and allows for better nutrition support by preventing fluid overload. CRRT is indicated for patients who cannot tolerate intermittent dialysis due to hemodynamic instability from their critical illness.
More Related Content
What's hot
anticoagulation CRRT .pptx
This document discusses anticoagulation for continuous renal replacement therapy (CRRT). It begins by outlining factors that can lead to clotting of CRRT filters and circuits. The main anticoagulation modalities discussed are heparin, low molecular weight heparin, citrate, and no anticoagulation. For each option, the mechanisms of action, advantages, disadvantages, dosing protocols, and typical filter life spans are summarized. Regional citrate anticoagulation is highlighted as it avoids systemic anticoagulation effects while effectively preventing clotting. Details are provided on citrate metabolism and calcium replacement to maintain safe ionized calcium levels.
Renal replacement therapy
This document summarizes renal replacement therapy modalities. It discusses that acute kidney injury affects 5% of hospitalized patients and increases mortality. The main renal replacement therapies are hemodialysis, peritoneal dialysis, and continuous renal replacement therapies. Hemodialysis removes water and solutes across a semipermeable membrane via diffusion and convection. Peritoneal dialysis utilizes the peritoneal membrane for solute and fluid removal. Choice of modality depends on patient factors and available resources. The goal of renal replacement therapy is to control fluid, electrolyte, and acid-base disturbances while providing adequate solute clearance.
2 prismaflex crrt basic components - seg 2
The document discusses the basic components of continuous renal replacement therapy (CRRT), including hemofilters, solutions, vascular access points, anticoagulation methods, and blood warmers. It provides details on the PrismaFlex CRRT system, including its disposable set, solutions, and flow control and fluid control units. The flow control unit contains pumps, pinch valves, and a patented deaeration chamber for air removal. The fluid control unit uses several scales to measure effluent, replacement, dialysate, and pre-blood pump fluids.
Advanced hemodynamic monitoring
This document discusses less invasive methods of advanced hemodynamic monitoring. It begins by explaining the key factors that affect hemodynamic conditions like cardiac output, including heart rate, intravascular volume, myocardial contraction, and vasoactivity. It then discusses several noninvasive and invasive monitoring methods and focuses on pulse wave contour analysis and transpulmonary thermodilution techniques. These techniques can provide continuous cardiac output measurements along with volumetric parameters through advanced analysis of arterial pressure waveforms and thermal dilution curves. The document concludes by outlining typical values of parameters measured and providing an example decision tree for fluid and drug therapy guided by hemodynamic monitoring.
Water copy
This document discusses water treatment for hemodialysis units. It notes that water quality significantly impacts patient outcomes. The summary is as follows:
1. Proper water treatment is essential for hemodialysis patients who are exposed to large volumes of water each week through dialysis.
2. The water treatment system uses various processes like carbon filtration, softening, reverse osmosis, and deionization to remove contaminants.
3. Strict policies, documentation, and staff education are needed to ensure the water treatment system operates safely and provides water that meets quality standards.
Perawatan Monitoring CVP dan Swans Ganz
Perawatan dan indentifikasi masalah seputar perawatan CVP dan Swans Ganz. Bukan hanya pada troubleshooting alatnya saj. Namun juga pada tindakan keseharian kita dalam menggunakan monitoring hemodinamik.
Monitoring Cvp
CVP digunakan untuk memantau tekanan vena sentral dan fungsi ventrikel kanan. Nilai normal CVP adalah 3-8 mmHg. Komplikasi yang dapat terjadi meliputi emboli udara, pneumotoraks, dan infeksi, namun dapat dicegah dengan teknik steril dan memantau tanda infeksi.
Fluid Fluid Overload: Poor Cosmetics or Bad Medicine
The document discusses the risks of fluid overload in critically ill patients and strategies for de-resuscitation. It summarizes evidence that a conservative fluid strategy after day 3 of critical care that aims for fluid balance equilibrium or negativity is associated with improved patient outcomes compared to more liberal fluid management. The key message is that fluid overload is an independent predictor of poor outcome, so the reasons for de-resuscitation are to avoid the pathophysiological effects of fluid overload.
Renal replacement therapy
- Renal replacement therapies are important in critical care for managing complications of renal failure such as fluid, electrolyte and acid-base imbalances. There are many questions around optimal therapy including timing, dose and modality.
- Acute kidney injury is common in the ICU and associated with worse outcomes. Continuous renal replacement therapies may provide more stable volume and chemistry control compared to intermittent therapies.
- High volume hemofiltration shows promise for removing inflammatory mediators in sepsis but optimal dose is still unclear. Renal replacement therapies have an important role beyond renal support as blood purification techniques.
Ventilasi mekanik
Ventilator adalah alat bantu pernapasan yang membantu proses ventilasi untuk menjaga oksigenasi tubuh. Ventilator dapat membantu pasien dengan gagal napas akibat berbagai penyebab seperti cedera kepala, infeksi otak, kelainan otot pernapasan, dan kelainan paru dan jantung. Pemberian ventilator harus sesuai dengan kondisi pasien dan diatur berdasarkan hasil analisis gas darah untuk mencegah komplikasi seperti gang
TEMPORARY PACE MAKER
TPM digunakan untuk mengobati gangguan sistem konduksi jantung sementara. TPM bekerja dengan memberikan impuls listrik ke jantung untuk menjaga irama kontraksi yang normal. Ada beberapa jalur pemasangan elektrode TPM, dan komponen utamanya adalah generator, kabel, dan elektrode. Pemasangan TPM harus dilakukan dengan hati-hati untuk mencegah komplikasi seperti infeksi atau pergeseran elektrode.
14 Konsep Dasar EKG
Dokumen tersebut memberikan ringkasan singkat tentang sistem konduksi jantung dan elektrokardiografi. Sistem konduksi jantung terdiri dari beberapa sel pacemaker yang mengeluarkan impuls untuk menciptakan depolarisasi dan repolarisasi. Elektrokardiografi merekam aktivitas listrik jantung untuk tujuan diagnostik gangguan jantung. Terdapat beberapa gelombang dan interval khas pada elektrokardiogram normal.
The four phases of intravenous fluid therapy: Manu Malbrain
This document discusses fluid management in intensive care patients. It notes that fluids are drugs that require appropriate dosing, timing, and de-escalation. Inappropriate fluid therapy can lead to hyperchloremic metabolic acidosis, acute kidney injury, and increased mortality. The key factors in empiric fluid therapy are considering patient risk factors for fluid overload and targeting fluids specifically for resuscitation, maintenance, or replacement needs rather than focusing solely on hemodynamic parameters. Fluid removal should begin when shock is resolved to avoid complications from fluid overload.
Crrt sudan 2017 dr. osama el shahat
Stage-based management of acute kidney injury (AKI) involves monitoring for progression from risk to injury to failure. For stage 1 (risk), monitoring to prevent progression is recommended. For stage 2 (injury), conservative therapy is recommended due to high risk of mortality/morbidity. For stage 3 (failure), renal replacement therapy (RRT) should be considered due to highest risk of death. Continuous renal replacement therapy (CRRT) is preferred for hemodynamically unstable patients and allows for slow correction while maintaining hemodynamic stability. Higher CRRT doses of 35 ml/kg/hr may improve survival compared to lower doses, though optimal dosing remains controversial.
Which cardiac output monitoring?
1) The document discusses choosing cardiac output monitoring devices for peri-operative and ICU settings. It considers devices' reliability with changing vascular resistance and ability to provide useful clinical information.
2) For peri-operative monitoring of high-risk surgical patients, less invasive devices using uncalibrated pulse contour analysis like Vigileo and Clearsight may be suitable when vascular resistance does not change significantly.
3) For ICU patients receiving vasopressors where resistance changes greatly, more reliable thermodilution methods like PiCCO, EV1000 and pulmonary artery catheter are recommended to measure cardiac output and assess ventricular function.
Dexmedetomidine in icu hashemian
Dexmedetomidine is a selective alpha-2 adrenergic receptor agonist used for sedation in the ICU. It provides "cooperative sedation" allowing easy patient awakening and assessment. Studies show dexmedetomidine reduces delirium and time on ventilators compared to midazolam and propofol. The most common side effects are hypotension and bradycardia. Dexmedetomidine has potential benefits for treating agitation, delirium, alcohol withdrawal syndrome, and may reduce opioid needs and cardiovascular risks in ICU patients.
less invasive hemodynamic monitoring
less invasive hemodynamic monitoringDepartment of Anesthesiology, Faculty of Medicine Hasanuddin University
Pendahuluan:
Tissue disoxia merupakan problema utama dari pasien2 baik pascabedah maupun pasien sakit kritis di ICU
Tissue disoxia dapat disebabkan oleh rendahnya DO2, gangguan mikrosirkulasi dan peningkatan kebutuhan metabolisme sistim selular
Berlanjut menjadi cytopathic hypoxia yang disebabkan oleh disfungsi mitokhondriaMode of ventilation
This document discusses respiratory failure and various modes of mechanical ventilation. It begins by distinguishing between respiratory failure and respiratory insufficiency. It then covers initiating mechanical ventilation using either volume ventilation or pressure ventilation. Various modes are discussed including volume-targeted modes like control, assist, SIMV+PS. Pressure-targeted modes like pressure control ventilation and PSV are also covered. The document discusses the challenges of ventilating ARDS patients and how newer dual modes and closed-loop modes can help minimize ventilator-induced lung injury while maintaining lung recruitment and pressures. It also introduces APRV and bi-level ventilation as newer modes to apply PEEP above the lower inflection point.
What's hot (20)
Fluid Fluid Overload: Poor Cosmetics or Bad Medicine
Fluid Fluid Overload: Poor Cosmetics or Bad Medicine
The four phases of intravenous fluid therapy: Manu Malbrain
The four phases of intravenous fluid therapy: Manu Malbrain
Viewers also liked
Prisma™ Priming And Troubleshooting
The document provides instructions for priming and troubleshooting the Prisma continuous renal replacement therapy (CRRT) machine. It describes how to power on the machine, calibrate the scales, select a patient and therapy, prime the tubing set, program therapy settings, connect the machine to the patient, and end a treatment. It also gives guidance on resolving common issues like pressure alarms, scale resets, fluid removal errors, and air in lines.
CRRT
CRRT (continuous renal replacement therapy) involves using an extracorporeal circuit connected to the patient via catheters to slowly remove fluid and toxins over 24 hours, mimicking the function of the kidneys. It was developed for critically ill patients who cannot tolerate the fluid shifts of intermittent hemodialysis. CRRT uses a semipermeable membrane to filter fluids and small molecules from the blood based on hydrostatic pressure gradients. It provides more hemodynamic stability than intermittent hemodialysis and allows for better nutrition support by preventing fluid overload. CRRT is indicated for patients who cannot tolerate intermittent dialysis due to hemodynamic instability from their critical illness.
Continuous renal replacement therapy in the adult intensive care unit
1. Continuous renal replacement therapy (CRRT) has become the standard treatment for acute renal failure in critically ill patients due to concerns about hemodynamic stability during intermittent hemodialysis.
2. There are several types of CRRT including continuous venovenous hemofiltration (CVVH), continuous venovenous hemodialysis (CVVHD), and continuous venovenous hemodiafiltration (CVVHDF).
3. CRRT works continuously over days to slowly remove fluid and waste from the blood, mimicking the native kidney function and allowing for greater hemodynamic stability compared to intermittent hemodialysis.
Basics of Continuous Renal Replacement Therapy
A very simple yet comprehensive presentation to understand the concept of CRRT and its implementation in Intensive Care Unit. Intended for the very beginners in ICU. After going through the presentation you will be able to say "Now I know it!"
CRRT workshop (Therapy overview I)
This document discusses continuous renal replacement therapy (CRRT). It begins by defining CRRT as any extracorporeal blood purification therapy intended to substitute for impaired renal function over an extended period of 24 hours per day. The document then discusses the reasons for CRRT, including removal of waste products, fluid, regulation of electrolytes and acid-base balance, prevention of further kidney damage, and hemodynamic stability. It provides examples of how CRRT can help in conditions like acute renal failure, congestive heart failure, sepsis, rhabdomyolysis, and intoxications by closely mimicking the functions of the native kidney over a continuous period of time.
Viewers also liked (6)
Continuous renal replacement therapy in the adult intensive care unit
Continuous renal replacement therapy in the adult intensive care unit
Similar to Priming dan Troubleshooting CRRT Edward Aquarius
Teknik pemeriksaan radiologi ct
Teknik pemeriksaan CT scan abdomen akut mencakup pemeriksaan CT abdomen rutin maupun darurat dengan atau tanpa injeksi kontrast. Pemeriksaan rutin dilakukan dengan persiapan maksimal untuk hasil yang akurat, sedangkan darurat dapat dilakukan tanpa persiapan. Teknik pemeriksaannya meliputi persiapan pasien dan alat, serta cara pelaksanaan pemeriksaan CT abdomen dengan atau tanpa injeksi kontrast secara intra
Kanulasi vena central
Dokumen tersebut membahas tentang Kanulasi Vena Central (KVS) atau Central Venous Pressure (CVP). KVS digunakan untuk mengukur tekanan vena sentral dan memberikan nutrisi, obat-obatan, atau cairan secara intravena. Prosedur KVS melibatkan memasukkan kateter ke pembuluh darah vena hingga ujungnya mencapai muara vena cava superior dan inferior. Dokumen tersebut juga membahas indikasi, persiapan, cara pelaksana
6. persiapan mesin HD.docx
Dokumen ini menjelaskan prosedur persiapan mesin dan peralatan hemodialisis di RSU Wisata UIT Makassar agar siap digunakan untuk menjalankan tindakan dialisis pada pasien dengan aman dan efektif. Langkah-langkahnya meliputi pengecekan air, listrik, dan peralatan seperti dialiser, AVBL, cairan dialisat, dan obat-obatan. Kemudian dilakukan test fungsi mesin dan priming untuk mengisi bagian ekstrakorp
Metering and regulating system
Stasiun gas berperan penting dalam mengalirkan gas ke pelanggan dengan mengatur tekanan, mengukur aliran, dan membagi aliran gas. Komponen kunci stasiun gas meliputi isolating joint, insulating joint, valve, actuator, pressure gauge, pressure transmitter, filter, meter orifice, chart recorder, PSDV, PCV, dan check valve—masing-masing berfungsi untuk mengisolasi sistem katodik, mengukur dan mengatur aliran gas, menyaring kontaminan, dan mengamankan sistem
Presentasi teori life support tentang ventilator
Tentang Alat Ventilator Pada Mata Kuliah Life Support di Teknik Elektromedik
Definisi anatomi
Terapi intravena adalah pemberian cairan, obat, dan nutrisi langsung ke dalam pembuluh darah untuk mengembalikan keseimbangan cairan tubuh, memberikan obat, transfusi darah, dan nutrisi. Teknik pemasangan infus meliputi persiapan pasien dan peralatan, pemilihan vena, membersihkan area penusukan, dan penusukan kateter ke dalam vena.
Diskusi CAPD - dr Ivan Virnanda Amu.pptx
1. Diskusi topik modul dialisis membahas prinsip dan perbandingan antara CAPD dan APD.
2. Menjelaskan berbagai cara insersi kateter dialisis peritoneal beserta keuntungan dan kerugian masing-masing.
3. Menjelaskan cara untuk mengukur adekuasi dialisis peritoneal atau CAPD.
PENUNTUN-HEMATOLOGI.docx
Buku ini memberikan pedoman bagi mahasiswa kedokteran untuk melakukan tes hematologi dasar seperti hitung sel darah, laju endap darah, dan golongan darah melalui teknik dan prosedur standar. Buku ini juga berisi gambar untuk memudahkan pemahaman konsep dan teknik-tekniknya.
Ventilasi Mekanik (Mechanical Ventilator) Eri Yanuar
Materi Ventilasi Mekanik (Mechanical Ventilation) disampaikan oleh Eri Yanuar Akhmad Budi Sunaryo, S.Kep., Ns., M.N.Sc.(I.C) pada seminar yang diselanggarakan oleh Berca Niaga Medika
Materi WS Hemodynamic monitoring 2022 (kang Yudi).pptx
Dokumen tersebut membahas tentang monitoring hemodinamik, termasuk definisi, tujuan, parameter yang diukur secara invasif dan noninvasif, cara pengukurannya, keuntungan dan kerugiannya. Secara khusus membahas tentang pengukuran tekanan arteri, tekanan vena sentral, dan kateter arteri pulmonal beserta cara kerjanya."
Penuntun praktikum hematologi
Buku penuntun ini memberikan pedoman teknik dan prosedur praktikum hematologi bagi mahasiswa kedokteran, mulai dari teknik pengambilan darah, tes hematologi dasar seperti hitung eritrosit dan leukosit, hingga tes lanjutan seperti golongan darah dan koagulasi darah. Buku ini dilengkapi gambar untuk memperjelas prosedur-prosedur tersebut.
Similar to Priming dan Troubleshooting CRRT Edward Aquarius (16)
Ventilasi Mekanik (Mechanical Ventilator) Eri Yanuar
Ventilasi Mekanik (Mechanical Ventilator) Eri Yanuar
Materi WS Hemodynamic monitoring 2022 (kang Yudi).pptx
Materi WS Hemodynamic monitoring 2022 (kang Yudi).pptx
Recently uploaded
Monitoring dan Evaluasi Program Pertolongan Pertama Pada Luka Psikologis.pdf
Monitoring dan Evaluasi Program Pertolongan Pertama Pada Luka Psikologis
PENJAGAAN PESAKIT DENGAN VENTILATOR Kursus Basic Resus Nursing HTJS.pptx
PENJAGAAN PESAKIT DENGAN VENTILATOR
PRESENTASI LAPORAN TUGAS AKHIR ASUHAN KEBIDANAN KOMPREHENSIF
Peningkatan status kesehatan ibu dan anak merupakan salah satu hal prioritas di Indonesia. Status derajat kesehatan ibu dan anak sendiri dapat dinilai dari jumlah AKI dan AKB. Pemerintah berupaya menerapkan program Sustainable Development Goals (SDGs) dengan harapan dapat menekan AKI dan AKB, tetapi kenyataannya masih tinggi sehingga tujuan dari penyusunan laporan tugas akhir ini untuk memberikan asuhan kebidanan secara komprehensif dari ibu hamil trimester III sampai KB.
Metode penelitian menggunakan Continuity of Care dengan pendokumentasian SOAP Notes. Subjek penelitian Ny. “H” usia 34 tahun masa kehamilan Trimester III hingga KB di PMB E Kecamatan Ngunut Kabupaten Tulungagung.
Hasil asuhan selama masa kehamilan trimester III tidak ada komplikasi pada Ny. “E”. Masa persalinan berjalan lancar meskipun terdapat kesenjangan dimana IMD dilakukan kurang dari 1 jam. Kunjungan neonatus hingga nifas normal tidak ada komplikasi, metode kontrasepsi memilih KB implant.
Kesimpulan asuhan pada Ny. “H” ditemukan kesenjangan antara kenyataan dan teori di penatalaksanaan, tetapi dalam pemberian asuhan ini kesenjangan masih dalam batas normal. Asuhan kebidanan ini diberikan untuk membantu mengurangi kemungkinan terjadi komplikasi pada saat masa kehamilan hingga KB.
Sejarah, Trend Isu Keperawatan Jiwa Dan Konsep Dasar Keperawatan Jiwa
Sejarah, Trend Isu Keperawatan Jiwa Dan Konsep Dasar Keperawatan Jiwa
keterampilan kader dan teknis penilaian tingkat kecakapan kader posyandu.pptx
Sosialisasi mengenai keterampilan kader dan teknis penilaian tingkat kecakapan kader posyandu di kabupaten bogor
PENYULUHAN SKRINING KESEHATAN USIA PRODUKTIF
paparan skrining usia produktif untuk orang awam dan kader
Recently uploaded (17)
Monitoring dan Evaluasi Program Pertolongan Pertama Pada Luka Psikologis.pdf
Monitoring dan Evaluasi Program Pertolongan Pertama Pada Luka Psikologis.pdf
PENJAGAAN PESAKIT DENGAN VENTILATOR Kursus Basic Resus Nursing HTJS.pptx
PENJAGAAN PESAKIT DENGAN VENTILATOR Kursus Basic Resus Nursing HTJS.pptx
PRESENTASI LAPORAN TUGAS AKHIR ASUHAN KEBIDANAN KOMPREHENSIF
PRESENTASI LAPORAN TUGAS AKHIR ASUHAN KEBIDANAN KOMPREHENSIF
Sejarah, Trend Isu Keperawatan Jiwa Dan Konsep Dasar Keperawatan Jiwa
Sejarah, Trend Isu Keperawatan Jiwa Dan Konsep Dasar Keperawatan Jiwa
Pengendalian Proses.pptx Mata kuliah manajemen mutu laboratorium
Pengendalian Proses.pptx Mata kuliah manajemen mutu laboratorium
keterampilan kader dan teknis penilaian tingkat kecakapan kader posyandu.pptx
keterampilan kader dan teknis penilaian tingkat kecakapan kader posyandu.pptx
Priming dan Troubleshooting CRRT Edward Aquarius
- 1. Edward ® Aquarius™ Priming and Troubleshooting Oleh : ARI P Pusat Jantung Nasional Harapan Kita Jakarta 2008
- 2. Menghidupkan Mesin Tekan tombol “ON/ OFF” di belakang– samping panel monitor. Tahan selama 3 detik. Di layar monitor akan tampak “self test running” dan “program versions running” TUNGGU.
- 3. Memilih Program Terapi Pilih pilihan terapi sesuai dengan yang diharapkan atau sesuai denagn instruksi medik. TEKAN ENTER dengan Trim Knob.
- 6. Memasang Aqualine ™ Tubing(1) Pasang BLD (Blood Leak Detector) di samping kiri mesin Pasang detektor replacement fluids pada tempatnya. Beberapa orang beranggapan boleh dipasang setelah priming selesai. Pasang return chamber dengan ujung bawahnya dijepit sempurna pada air detector. Masukkan tubing return setelah air detector ke dalam clamp. Digunakan untuk safety bila terjadi bubble.
- 7. Memasang Aqualine ™ Tubing(2) Pasang line replacement fluids dan gantung replacement fluids pada tempatnya. Pasang warmer pada plate yang tersedia di sebelah kanan mesin. Kunci dengan sempurna. Pasang masing masing tranduser pada tempatnya sesuai dengan gambar
- 9. Memasang Priming dan Effluent Bag Pasang collecting filtrate bag di bagian bawah depan mesin Pasang collecting priming bag di tiang, sambungkan dengan line arteri (merah)
- 11. Memasang Replacemet Fluids Pasang priming fluids ( ± 1500 cc saline dengan heparin 1:5) di tiang, sambungkan dengan line vena (biru) Jangan lupa beri tambahan threeway stopcock untuk test clamp. Pasang line replacement fluids dan gantung replacement fluids pada tempatnya.
- 14. Memprogram Terapi Lakukan pemrograman terapi sesuai dengan yang diharapkan atau sesuai dengan instruksi.