therapeutic options in acute renal failure

Send This

Download

Comment

Favourite

more

Rating :

Rate It:

Embed :

Post a comment

Post Comment on Twitter Post Comment on SlideWorld

Comments:

Subscribe to follow-up comments

1 Favorites

paogag, favourited this 3 Years ago.

First Prev [1] Next Last

Notes

Hide Notes

Slide 1 :

Therapeutic options in ARF Dr Salwa Ibrahim,MD MRCP Cairo University 24/5/07

Slide 2 :

Incidence Incidence of ARF 50-100 new cases /year/pmp Hospital acquired ARF 2-5% of Admissions 23 % of ICU admissions

Slide 3 :

ARF in “critically ill patients”, severe CVS, respiratory and metabolic instability, sepsis…multiple organ dysfunction ARF in ICU

Slide 4 :

Mortality in ARF Liano et al, 1996

Slide 5 :

Classification system for AKI

Slide 6 :

Slide 7 :

Indications for RRT in critically ill ARF patients

Slide 8 :

Prophylactic Dx in ARF (traumatic) Conger et al, 1975

Slide 9 :

RRT MODALITIES

Slide 10 :

Intermittent Hemodialysis

Slide 11 :

Peritoneal Dialysis

Slide 12 :

CCRT 1977, Kramer described CAVH

Slide 13 :

Slide 14 :

Slide 15 :

Slide 16 :

Slide 17 :

Slide 18 :

SCUF

Slide 19 :

CRRT vs. IHD Ronco C, 2001

Slide 20 :

Hemodynamics during HD and CVVH

Slide 21 :

CRRT: Removal of inflammatory mediators De Vriese A, et al 1999

Slide 22 :

Slide 23 :

Slide 24 :

8-12 hours Dialysate flow 100-300 ml/m UFR variable BFR 100-300ml/m SLED/EDD (Hybrid therapy)

Slide 25 :

Slide 26 :

SLED/EDD Beth Israel Medical Center (NY) University of Arkansas for medical services University of California at Davis Medical school hospital, Hannover Middlemore hospital, Auckland University of Parma, Italy

Slide 27 :

Slide 28 :

Slide 29 :

Slide 30 :

Modality IHD vs. CRRTDose of RRTTiming of RRTSeverity of illness

Slide 31 :

Slide 32 :

CRRT vs. IHD in ARF Mehta et al, 1996

Slide 33 :

CRRT vs. IHD in ARF Sandy et al, 1998

Slide 34 :

CRRT vs. IHD in ARF Augustine et al, 2004

Slide 35 :

Effect of severity of illness on mortality in the intermittent hemodialysis and continuous renal replacement therapy groups. Mehta et al, Kidney International, 2001 543 282

Slide 36 :

CRRT vs. IHD

Slide 37 :

The Lancet 2006; 368:379-385Continuous VVHDF Vs, IHD for ARF in patients with MODS: a multicentre randomised trial Findings Rate of survival at 60-days did not differ between the groups (32% in the IHD group versus 33% in CRRT group). Vinsonneau C, et al

Slide 38 :

Slide 39 :

www.nature.com/clinicalpractice/neph

Slide 40 :

DOSE OF RRT

Slide 41 :

Slide 42 :

Slide 43 :

Frequent dialysis is required for hypercatabolic patients C BUN 60 mg/dl B BUN 80 mg/dl A BUN 100 mg/dl Clark, WR et al J Am Soc Nephrol 1997

Slide 44 :

Slide 45 :

Timing Of Initiation of RRT

Slide 46 :

Slide 47 :

Slide 48 :

Summary Overall prognosis is poor in MODS Mortality linked to number of failing organs 2 organs….60% mortality 3 organs….92%mortality Uncertainty about the best modality

Slide 49 :

Summary Treatment should be individualized Patient factors (catabolic state, hemodynamics) Hospital facilities, knowledge and training of nursing staff, cost

Slide 50 :

Thank You

CHF Diastolic Heart ...

Management of Conges...

Acute Coronary Syndr...

Sleep Apnea and Hear...

Acute Hepatitis B Wh...

Acute Coronary Syndr...

Free Powerpoint Templates

	salwaibrahim@hotmail.com 5 Years ago.



4283 Views, 2 favourite
PowerPoint Slide Presentation on
More By User Flag as inappropriate Select your reason for flagging this presentation as inappropriate. If needed, use the feedback form to let us know more details. Cancel