11/19/2016 MỘT SỐ CẬP NHẬT VỀ LỌC MÁU TRONG HỒI SỨC TÍCH CỰC GS.TS Nguyễn Gia Bình Khoa Hồi sức tích cực bệnh viện Bạch Mai ĐT 0439959015 1/28 11/19/2016 MỘT SỐ THUẬT NGỮ  AVVH : Accelerated veno-venous hemofiltration;  CPE : Continuous plasma exchange  T CPFA : Continuous plasmafiltration coupled with adsorption  CRRT : Continuous renal replacement therapy  CVVH : Continuous veno-venous hemofiltration  CVVHD :Continuous veno-venous hemodialysis;  CVVHDF : Continuous venovenoushemodiafiltration  CVVHFD :Continuous veno-venous high-flux dialysis 11/19/2016 MỘT SỐ THUẬT  ED : Extended dialysis  EDD : Extended daily dialysis  EDDf : Extended daily dialysis  FPSA : Fractionated plasma separation and  HVHF:      NGỮ T with filtration; adsorption High-volume hemofiltration; IHD : Intermittent hemodialysis; IHDF : Intermittent hemodiafiltration; IHF : Intermittent hemofiltration; IHFD : Intermittent high-flux dialysis MOST : Multiple organ support therapy 11/19/2016 MỘT SỐ THUẬT NGỮ T  PIRRT: T Prolonged intermittent renal replacement therapy;  RRT : Renal replacement therapy;  SCUF : Slow continuous ultrafiltration;  SLED : Sustained low-efficiency dialysis;    SLEDD:Slow low-efficiency extended daily SPAD: dialysis; Single pass albumin dialysis; TPE : Therapeutic plasma exchange;  VHVHF : Very high-volume hemofiltration  MARS : Molecular adsorbent recirculating system 11/19/2016 C RRr T VS IHD No afewnts Ocds ratio (00% Cl) r IRRT CRRT 20) 46165 48JS8 1111 ( 0.38, 82) 2~!\1,8 34152 sirm:pi:on r(1 99~ C 50 ( 0.21 hierdof111( 1994) (J pm ,00 ( 0.19, :5.24) 14f20 memla ~2001) BQ ( D1, 3.52) 5419.4 40/82 gasparu-lli:c (200S) i.67 ( 0"74 3.78) 37152 31152 27/40 28MO {2001) fiHltQJ.JSlirB (J (20 04 )r llfl'hl~r (2005} vinEO li1llEIBll 1(2006) linsr( d} · Overa11 O L91 ( 0.45 LOO) O 95 ( 61, L-18) C.83 ( 0.53, 131) (J 2;5 .5 89 ( 0.35, 22') 99 ( 0.7B1 26.) 7/10 28155 34llO 1181175 12611941 901144 100fl72 -4591726 -4,3 21671 Odds mt.i o Favours CRRlli Fa\QJl's IRRT Fil[lllilil~ f orrest p:1ot o~ ~oo oo odds ratto'S for lllTiOTl:allty frnrn nl rte -andomnzoo trials, Cf, co1Uiid1e1iu:e iJ1terwd; CR.RT oonltl11W1ous renal ~epta;ei!11111ent tnernpy; IRR'f interwlitent renail ~l:aament tr1~rapy  Sean M Bagshaw et al Continuous versus intermittent renal replacement therapy for critically ill patients with acute kidney injury: A meta-analysis Crit Care Med 2008 Vol 36, No 5/ 11/19/2016 MỘT SỐ PHƯƠNG PHÁP LỌC MÁU TJ\T~T ~~ T \~T A~ TTr' T · - CVVHO Q Q '100-200ml/mm Qu 2·4ml/m1n J0-30ml/mln CVVHFO.Sl.CD a Q,•100-lOOml/m,n •IO-JOml/ Qu,•JO- Oml/1 Q.=J 00-200ml/ma, Q ,._u,•2-Sml/mrn Con ,, cour,lftl w,th CWH or CWHOF rorlonJ HP Blood in , Blood o Q,, CJ.raJ00-200m//m n Our u!Licl.fiLidlion Row rdle, Or, wly,Wte flow rate,~ tot.al r~c.'f\l now ,::zo.:samv; rate, O,r.1 E.-flluent now rdt.e Q, 11 rep&.ic.c."1"1ent pt~mc1 flow rate, t CWH or CVVHCN Con b• coup/«/ w,th CVVH or CVVHOF n CJ.=100·200ml/m,,, K J5-45ml/Ko/h Ca" ,, couo 'ft/ w•th CWH or CWHDF Fig M 11Jl CXl.racotporcal chc!f~ O,,u, plrivna ultrafi:ltration now rat,;, scvr