CVVH, CVVHD and CVVHDF: These terms will soon no longer be a "black box" for you! This book is aimed at physicians and nurses in intensive care units who want to both apply and understand continuous renal replacement procedures. Step-by-step, the functionalities and characteristics of all common renal replacement procedures, such as continuous veno-venous hemofiltration, hemodialysis, and hemodiafiltration, are explained in a comprehensible manner, and the clinical implications of the parameters to be set are described. A separate chapter is devoted to the topic of citrate anticoagulation, an understanding of which is essential when using continuous renal replacement procedures. With this knowledge, the most suitable therapy can be selected for each patient and optimally adapted to the patient's needs.
Author(s): Daniel Heise
Publisher: Springer
Year: 2022
Language: English
Pages: 81
City: Berlin
Preface
Acknowledgements
Contents
About the Author
1: Historical Developments
1.1 A Short Journey Through Time
2: Proven to the Present Day: Continuous Haemofiltration
2.1 First Continuous Renal Replacement Therapy
2.2 Technical Developments
2.2.1 Blood Pump
2.2.2 Filtrate Pump
2.2.3 Substitution Solution
2.3 Influence of the Molecule Size on the Filtration Process
Reference
3: Parameters of Renal Replacement Therapy
3.1 Fluid Removal and Therapeutic Dose: Please Do Not Confuse!
3.2 Fluid Removal
3.3 Therapeutic Dose
3.4 How Should the Blood Flow QB Be Set?
3.5 Predilution: Trade-Off Between Filter Life and Detoxification Performance
3.6 Summary of Continuous Veno-Venous Haemofiltration (CVVH)
References
4: Haemodialysis: Exchange Without Flow
4.1 Diffusion as a Basic Principle
4.1.1 Selective Diffusion
4.1.2 Continuous Diffusion in Counterflow Principle
4.2 Therapeutic Dose of Haemodialysis
4.3 Fluid Removal
4.4 Influence of the Molecule Size on the Diffusion Process
4.5 Summary Continuous Venovenous Haemodialysis (CVVHD)
5: Best of Both Worlds: Haemodiafiltration
5.1 From Haemodialysis with Fluid Removal to Haemodiafiltration
5.2 Therapeutic Dose
5.3 Fluid Removal
5.4 Summary Continuous Venovenous Haemodiafiltration (CVVHDF)
6: If Life Gives You Lemons: Ask for Citrate Anticoagulation
6.1 Anticoagulation in Continuous Renal Replacement Procedures
6.2 Functionality
6.3 Effectiveness of Anticoagulation
6.4 Blood pH
6.4.1 Metabolic Acidosis
6.4.2 Metabolic Alkalosis
6.5 Systemic Calcium
6.6 Addition of Citrate: A Kind of Predilution
6.7 Citrate Anticoagulation in Liver Failure
6.8 Summary of Citrate Anticoagulation
Reference
7: It Is Not Always Just About Flow: Pressure Parameters of Renal Replacement Therapy
7.1 Pressure, Flow and Resistance
7.1.1 Arterial Pressure
7.1.2 Prefilter Pressure
7.1.3 Venous Pressure
7.1.4 Ultrafiltrate Pressure and Trans-membrane Pressure
8: Let’s Go!
8.1 Who Needs Which Renal Replacement Procedure and When?
8.2 Which Modality (Haemodialysis, Haemofiltration or Haemodiafiltration)?
8.3 What Treatment Parameters?
8.4 Which Anticoagulation?
Index
