CN112190779A - CRRT pipeline replacement method - Google Patents
CRRT pipeline replacement method Download PDFInfo
- Publication number
- CN112190779A CN112190779A CN202011129781.6A CN202011129781A CN112190779A CN 112190779 A CN112190779 A CN 112190779A CN 202011129781 A CN202011129781 A CN 202011129781A CN 112190779 A CN112190779 A CN 112190779A
- Authority
- CN
- China
- Prior art keywords
- patient
- blood
- crrt
- pipeline
- tube
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
- 238000000034 method Methods 0.000 title claims abstract description 32
- 239000008280 blood Substances 0.000 claims abstract description 46
- 210000004369 blood Anatomy 0.000 claims abstract description 46
- 238000011010 flushing procedure Methods 0.000 claims abstract description 18
- 210000003462 vein Anatomy 0.000 claims abstract description 16
- OZBAVEKZGSOMOJ-MIUGBVLSSA-N glycitin Chemical compound COC1=CC(C(C(C=2C=CC(O)=CC=2)=CO2)=O)=C2C=C1O[C@@H]1O[C@H](CO)[C@@H](O)[C@H](O)[C@H]1O OZBAVEKZGSOMOJ-MIUGBVLSSA-N 0.000 claims abstract description 8
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 8
- XJTZHGNBKZYODI-UHFFFAOYSA-N Glycitin Natural products OCC1OC(Oc2ccc3OC=C(C(=O)c3c2CO)c4ccc(O)cc4)C(O)C(O)C1O XJTZHGNBKZYODI-UHFFFAOYSA-N 0.000 claims abstract description 4
- 230000010100 anticoagulation Effects 0.000 claims abstract description 4
- 230000017531 blood circulation Effects 0.000 claims abstract description 4
- 230000006996 mental state Effects 0.000 claims abstract description 4
- 230000001954 sterilising effect Effects 0.000 claims abstract description 4
- HTTJABKRGRZYRN-UHFFFAOYSA-N Heparin Chemical compound OC1C(NC(=O)C)C(O)OC(COS(O)(=O)=O)C1OC1C(OS(O)(=O)=O)C(O)C(OC2C(C(OS(O)(=O)=O)C(OC3C(C(O)C(O)C(O3)C(O)=O)OS(O)(=O)=O)C(CO)O2)NS(O)(=O)=O)C(C(O)=O)O1 HTTJABKRGRZYRN-UHFFFAOYSA-N 0.000 claims description 10
- 229960002897 heparin Drugs 0.000 claims description 10
- 229920000669 heparin Polymers 0.000 claims description 10
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims description 8
- 230000008859 change Effects 0.000 claims description 7
- 238000005070 sampling Methods 0.000 claims description 7
- 238000001802 infusion Methods 0.000 claims description 6
- 239000011780 sodium chloride Substances 0.000 claims description 6
- 210000003191 femoral vein Anatomy 0.000 claims description 4
- 239000000243 solution Substances 0.000 claims description 4
- 238000002627 tracheal intubation Methods 0.000 claims description 4
- 101710205660 Calcium-transporting ATPase Proteins 0.000 claims description 3
- 101710134161 Calcium-transporting ATPase sarcoplasmic/endoplasmic reticulum type Proteins 0.000 claims description 3
- 230000002159 abnormal effect Effects 0.000 claims description 3
- 230000000747 cardiac effect Effects 0.000 claims description 3
- 238000004140 cleaning Methods 0.000 claims description 3
- 239000000385 dialysis solution Substances 0.000 claims description 3
- 238000001914 filtration Methods 0.000 claims description 3
- 239000012530 fluid Substances 0.000 claims description 3
- 239000002906 medical waste Substances 0.000 claims description 3
- 238000002360 preparation method Methods 0.000 claims description 3
- 230000033764 rhythmic process Effects 0.000 claims description 3
- 238000000926 separation method Methods 0.000 claims description 3
- 230000002792 vascular Effects 0.000 claims description 3
- 238000001990 intravenous administration Methods 0.000 claims description 2
- 239000002504 physiological saline solution Substances 0.000 claims description 2
- 230000002262 irrigation Effects 0.000 claims 1
- 238000003973 irrigation Methods 0.000 claims 1
- 238000011282 treatment Methods 0.000 abstract description 11
- 230000000694 effects Effects 0.000 abstract description 6
- 230000002411 adverse Effects 0.000 abstract description 3
- 238000001179 sorption measurement Methods 0.000 description 4
- 239000006185 dispersion Substances 0.000 description 3
- 239000007788 liquid Substances 0.000 description 3
- 238000000746 purification Methods 0.000 description 3
- 239000000126 substance Substances 0.000 description 3
- 206010018852 Haematoma Diseases 0.000 description 2
- 238000010790 dilution Methods 0.000 description 2
- 239000012895 dilution Substances 0.000 description 2
- 238000001631 haemodialysis Methods 0.000 description 2
- 230000000322 hemodialysis Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000023555 blood coagulation Effects 0.000 description 1
- 238000010241 blood sampling Methods 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 238000002615 hemofiltration Methods 0.000 description 1
- 230000001951 hemoperfusion Effects 0.000 description 1
- 230000023597 hemostasis Effects 0.000 description 1
- 230000013632 homeostatic process Effects 0.000 description 1
- 230000003907 kidney function Effects 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 230000035699 permeability Effects 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 238000012959 renal replacement therapy Methods 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3607—Regulation parameters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3643—Priming, rinsing before or after use
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
- A61M1/3655—Arterio-venous shunts or fistulae
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
- A61M1/3656—Monitoring patency or flow at connection sites; Detecting disconnections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
- A61M1/3659—Cannulae pertaining to extracorporeal circulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3672—Means preventing coagulation
Abstract
The invention discloses a CRRT pipeline replacing method, which comprises the following steps: step 1: confirming the identity information of a patient, checking the case, summarizing the reason of blood return, observing the mental state, inquiring the problem of simple self condition, and detecting by using a professional instrument; step 2: sterilizing a deep vein cannula according to an aseptic operation procedure, and preparing a 5ml syringe for holding 2ml of glycitin water, a 20ml empty syringe and a V tube; step 3: performing pipeline pre-flushing, and adjusting the body position of a patient and the position direction of the catheter; step 4: the one end of straining the pipeline with the blood is connected with the dark vein catheterization's of patient one end that corresponds, drives the blood pump, and the velocity of blood flow is not higher than 100ml/min, starts the anticoagulation, and blood dredges to the filter and takes a sample in the sample connection, and blood dredges to V pipe one end, pressure sensor sensing signal, blood pump close, connects the dark vein catheterization's of patient V pipe one end. The CRRT pipeline replacement method is simple and convenient to operate, can keep the treatment progress of the patient, does not cause additional adverse effect on the physical condition of the patient, and is safe to use.
Description
Technical Field
The invention relates to the technical field of CRRT pipeline replacement, in particular to a CRRT pipeline replacement method.
Background
CRRT continuous renal replacement therapy is defined as a blood purification treatment technology for continuously and slowly removing water and solutes in an extracorporeal blood purification way to replace the renal function, compared with the common hemodialysis, CRRT prolongs the blood purification treatment time and reduces the treatment efficiency in unit time, so that the influence of the solute concentration and volume change in blood on the organism is minimized, and meanwhile, a filter with high permeability and good biocompatibility is adopted to provide extremely important homeostasis balance for the treatment of severe patients, and the main ways of removing the solutes of CRRT are 3: dispersion, convection and adsorption, different treatment modes and different removal mechanisms, hemodialysis mainly adopts dispersion removal, hemofiltration mainly adopts convection and partial adsorption removal, immunoadsorption and hemoperfusion mainly adopt adsorption as a main removal mode, different substance removal modes are different, small molecular substance dispersion removal effects are good, medium and large molecular substances have good convection and adsorption removal effects, and therefore, a proper treatment mode is selected according to different clinical requirements to determine treatment dosage;
present CRRT pipeline replacement technique uses and has certain limitation, can cause certain adverse effect to the patient when the operation is improper to current CRRT pipeline replacement step operation is comparatively loaded down with trivial details, and medical personnel's work load is big, increases the probability of error easily, and operating cost is higher.
Disclosure of Invention
The invention mainly aims to provide a CRRT pipeline replacing method which has high use safety, can effectively reduce complications of patients, is simple to operate and relatively low in cost and can effectively solve the problems in the background art.
In order to achieve the purpose, the invention adopts the technical scheme that: a CRRT pipeline replacing method comprises the following steps:
step 1: confirming the identity information of a patient, checking the case, summarizing the reason of blood return, observing the mental state, inquiring the problem of simple self condition, and detecting by using a professional instrument;
step 2: sterilizing a deep vein cannula according to an aseptic operation procedure, and preparing a 5ml syringe for holding 2ml of glycitin water, a 20ml empty syringe and a V tube;
step 3: performing pipeline pre-flushing, and adjusting the body position of a patient and the position direction of the catheter;
step 4: connecting one end of a blood filtering pipeline with the corresponding end of a deep vein catheterization of a patient, starting a blood pump, starting anticoagulation when the blood flow speed is not higher than 100ml/min, sampling at a sampling port when the blood is dredged to a filter, leading the blood to one end of a V-shaped pipe, sensing a signal by a pressure sensor, closing the blood pump, and connecting one end of the V-shaped pipe of the deep vein catheterization of the patient;
step 5: separating the venipuncture part of a patient, simultaneously separating the original CRRT pipeline, connecting the venous end of the puncture tube with the venous end of the new CRRT pipeline, and connecting the arterial end with the venous end;
step 6: after the arterial end and the venous end of the patient are connected again, the blood pump is started again, the flow rate is gradually increased but not higher than 180ml/min, and the cardiac rhythm change and BP change of the patient are closely concerned at the moment;
step 7: when the flow rate of the blood pump rises in the steps, the fluid infusion amount, the dialysis fluid amount and the water removal amount need to be adjusted step by step;
step 8: connecting the calcium pump with a tee joint from one end of the loop;
step 9: selecting a blood returning program, controlling the blood returning flow rate to be 80-100ml/min, and disconnecting the V-shaped tube end;
step 10: flushing residual blood in the indwelling tube, and simultaneously extracting 2ml of heparin and 2ml of saline to inject into the indwelling tube;
step 11: screwing each port by using a sterile heparin cap, and properly wrapping by using a sterile dressing;
step 12: and (4) recording the data of the patient, observing CRRT parameters and cleaning medical waste.
Preferably, the preparation articles in Step2 further comprise a disposable sterile towel, a tee, an infusion set and physiological saline.
Preferably, 20ml saline is used for indwelling tube flushing in Step 10.
Preferably, NS2000ml + heparin 100mg is used for pre-flushing the pipeline in Step3, the pre-flushing is completed when bubbles are exhausted during the pre-flushing, and whether the connection parts are firmly connected or not needs to be confirmed when the pipeline is connected with a patient.
Preferably, Step 13: when the vascular access is abnormal in Step4, the solution method comprises the steps of firstly, readjusting the body position of the patient; secondly, adjusting and observing the position or the direction of the connecting pipe; thirdly, the arteriovenous ends are reversely connected, and the recirculation rate is increased.
Preferably, at Step4-11, if an extravascular disconnection occurs, a line replacement should be performed, prohibiting re-access to the patient.
Preferably, Step4, the femoral vein is selected using a percutaneous puncture cannula and intravenous placement.
Preferably, the sterile dressing in Step11 is covered over the intubation site with sterile gauze or a transparent, translucent dressing.
Preferably, Step5 does not need to use a sterile towel to wipe the vein end opening of the puncture tube during the original CRRT separation process, and adopts a repeated rubbing operation mode.
The invention has the following beneficial effects:
the CRRT pipeline replacement method can keep the treatment progress of the patient, does not cause additional adverse effect on the physical condition of the patient, and is safe to use.
The CRRT pipeline replacement method can effectively reduce the complications of patients and avoid the influence on the state of illness caused by pipeline replacement.
The CRRT pipeline replacement method and the CRRT pipeline replacement device have small medicine loss, and can reduce the treatment economic burden of patients.
The CRRT pipeline replacement method is simple and convenient to operate, and the workload of medical personnel can be reduced.
Of course, it is not necessary for any product in which the invention is practiced to achieve all of the above-described advantages at the same time.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below, and it should be understood that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Example 1
A CRRT pipeline replacing method comprises the following steps:
step 1: confirming the identity information of a patient, checking the case, summarizing the reason of blood return, observing the mental state, inquiring the problem of simple self condition, and detecting by using a professional instrument;
step 2: sterilizing a deep vein cannula according to an aseptic operation procedure, and preparing a 5ml syringe for holding 2ml of glycitin water, a 20ml empty syringe and a V tube;
step 3: performing pipeline pre-flushing, and adjusting the body position of a patient and the position direction of the catheter;
step 4: connecting one end of a blood filtering pipeline with the corresponding end of a deep vein catheterization of a patient, starting a blood pump, starting anticoagulation when the blood flow speed is not higher than 100ml/min, sampling at a sampling port when the blood is dredged to a filter, leading the blood to one end of a V-shaped pipe, sensing a signal by a pressure sensor, closing the blood pump, and connecting one end of the V-shaped pipe of the deep vein catheterization of the patient;
step 5: separating the venipuncture part of a patient, simultaneously separating the original CRRT pipeline, connecting the venous end of the puncture tube with the venous end of the new CRRT pipeline, and connecting the arterial end with the venous end;
step 6: after the arterial end and the venous end of the patient are connected again, the blood pump is started again, the flow rate is gradually increased but not higher than 180ml/min, and the cardiac rhythm change and BP change of the patient are closely concerned at the moment;
step 7: when the flow rate of the blood pump rises in the steps, the fluid infusion amount, the dialysis fluid amount and the water removal amount need to be adjusted step by step;
step 8: connecting the calcium pump with a tee joint from one end of the loop;
step 9: selecting a blood returning program, controlling the blood returning flow rate to be 80-100ml/min, and disconnecting the V-shaped tube end;
step 10: flushing residual blood in the indwelling tube, and simultaneously extracting 2ml of heparin and 2ml of saline to inject into the indwelling tube;
step 11: screwing each port by using a sterile heparin cap, and properly wrapping by using a sterile dressing;
step 12: and (4) recording the data of the patient, observing CRRT parameters and cleaning medical waste.
Wherein, the preparation articles in Step2 also comprise a disposable sterile towel, a tee joint, an infusion set and normal saline.
Among them, 20ml of saline was used for indwelling tube flushing in Step 10.
The NS2000ml + heparin 100mg is used for pre-flushing the pipeline in Step3, the pre-flushing is finished when bubbles are exhausted during the pre-flushing, and whether the connection parts are firmly connected or not needs to be confirmed when the pipeline is connected with a patient.
Wherein, Step 13: when the vascular access is abnormal in Step4, the solution method comprises the steps of firstly, readjusting the body position of the patient; secondly, adjusting and observing the position or the direction of the connecting pipe; thirdly, the arteriovenous ends are reversely connected, and the recirculation rate is increased.
In Step4-11, if the catheter is taken off, the catheter should be replaced, and the patient is prohibited from being re-connected, so as to ensure the sanitation and safety.
In Step4, a percutaneous puncture cannula is used, and a femoral vein is selected for venous catheterization, so that the hematoma incidence is reduced, and the operation is simple and convenient.
Wherein, sterile gauze or transparent and semitransparent dressing is used for covering the intubation part in the sterile dressing in Step11, so that the sanitation is kept.
In Step5, the vein end opening of the puncture tube is wiped by using a sterile towel in the original CRRT pipeline separation process, and the repeated friction operation mode is adopted.
Example 2
Aiming at the specific operation principle of the method, the percutaneous puncture intubation is utilized in Step4, and the femoral vein is selected as the vein catheterization, so that the compression hemostasis effect is ensured, the hematoma incidence rate is reduced, the puncture is convenient, the technical requirement is low, the Step11 tube sealing method in the technical scheme is that the normal saline is firstly used, then the heparin liquid is used, the head end of the catheter is wrapped by a sterile treatment towel, the Step4 blood coagulation prevention mode in the scheme can be diluted, the former dilution is that the replacement liquid and the arterial end blood are mixed and then enter the filter, the service life of the filter is prolonged, the later dilution is that the replacement liquid and the blood purified by the filter are mixed and then flow back into the body, the blood sampling and administration at the sampling port are reduced, the blood pump is not easily closed, and the monitoring is enhanced.
In the description herein, references to the description of "one embodiment," "an example," "a specific example" or the like are intended to mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above do not necessarily refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.
The preferred embodiments of the invention disclosed above are intended to be illustrative only. The preferred embodiments are not intended to be exhaustive or to limit the invention to the precise embodiments disclosed. Obviously, many modifications and variations are possible in light of the above teaching. The embodiments were chosen and described in order to best explain the principles of the invention and the practical application, to thereby enable others skilled in the art to best utilize the invention. The invention is limited only by the claims and their full scope and equivalents.
Claims (9)
1. A CRRT pipeline replacing method is characterized in that: the method comprises the following steps:
step 1: confirming the identity information of a patient, checking the case, summarizing the reason of blood return, observing the mental state, inquiring the problem of simple self condition, and detecting by using a professional instrument;
step 2: sterilizing a deep vein cannula according to an aseptic operation procedure, and preparing a 5ml syringe for holding 2ml of glycitin water, a 20ml empty syringe and a V tube;
step 3: performing pipeline pre-flushing, and adjusting the body position of a patient and the position direction of the catheter;
step 4: connecting one end of a blood filtering pipeline with the corresponding end of a deep vein catheterization of a patient, starting a blood pump, starting anticoagulation when the blood flow speed is not higher than 100ml/min, sampling at a sampling port when the blood is dredged to a filter, leading the blood to one end of a V-shaped pipe, sensing a signal by a pressure sensor, closing the blood pump, and connecting one end of the V-shaped pipe of the deep vein catheterization of the patient;
step 5: separating the venipuncture part of a patient, simultaneously separating the original CRRT pipeline, connecting the venous end of the puncture tube with the venous end of the new CRRT pipeline, and connecting the arterial end with the venous end;
step 6: after the arterial end and the venous end of the patient are connected again, the blood pump is started again, the flow rate is gradually increased but not higher than 180ml/min, and the cardiac rhythm change and BP change of the patient are closely concerned at the moment;
step 7: when the flow rate of the blood pump rises in the steps, the fluid infusion amount, the dialysis fluid amount and the water removal amount need to be adjusted step by step;
step 8: connecting the calcium pump with a tee joint from one end of the loop;
step 9: selecting a blood returning program, controlling the blood returning flow rate to be 80-100ml/min, and disconnecting the V-shaped tube end;
step 10: flushing residual blood in the indwelling tube, and simultaneously extracting 2ml of heparin and 2ml of saline to inject into the indwelling tube;
step 11: screwing each port by using a sterile heparin cap, and properly wrapping by using a sterile dressing;
step 12: and (4) recording the data of the patient, observing CRRT parameters and cleaning medical waste.
2. The CRRT pipeline replacement method according to claim 1, wherein: the preparation articles in Step2 also comprise a disposable sterile towel, a tee joint, an infusion set and physiological saline.
3. The CRRT pipeline replacement method according to claim 1, wherein: 20ml saline was used for indwelling tube irrigation in Step 10.
4. The CRRT pipeline replacement method according to claim 1, wherein: NS2000ml and heparin 100mg are used for pipeline pre-flushing in Step3, the pre-flushing is finished when bubbles are exhausted during the pre-flushing, and whether the connection parts are firmly connected or not needs to be confirmed when the device is connected with a patient.
5. The CRRT tubing replacement method of claim 1,
step 13: when the vascular access is abnormal in Step4, the solution method comprises the steps of firstly, readjusting the body position of the patient; secondly, adjusting and observing the position or the direction of the connecting pipe; thirdly, the arteriovenous ends are reversely connected, and the recirculation rate is increased.
6. The CRRT pipeline replacement method according to claim 1, wherein: in Step4-11, if the catheter is out of the tube, the tube should be replaced and re-access to the patient is prohibited.
7. The CRRT pipeline replacement method according to claim 1, wherein: in Step4, the femoral vein is selected using a percutaneous puncture cannula and intravenous catheterization.
8. The CRRT pipeline replacement method according to claim 1, wherein: the sterile dressing in Step11 is covered on the intubation position by using sterile gauze or transparent and semitransparent dressing.
9. The CRRT pipeline replacement method according to claim 1, wherein: in Step5, the vein end opening of the puncture tube is wiped by using a sterile towel in the original CRRT pipeline separation process, and the repeated friction operation mode is adopted.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011129781.6A CN112190779A (en) | 2020-10-21 | 2020-10-21 | CRRT pipeline replacement method |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011129781.6A CN112190779A (en) | 2020-10-21 | 2020-10-21 | CRRT pipeline replacement method |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN112190779A true CN112190779A (en) | 2021-01-08 |
Family
ID=74010457
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202011129781.6A Pending CN112190779A (en) | 2020-10-21 | 2020-10-21 | CRRT pipeline replacement method |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN112190779A (en) |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109260535A (en) * | 2018-09-10 | 2019-01-25 | 广州医科大学附属第医院 | A kind of CRRT pipeline replacing options |
-
2020
- 2020-10-21 CN CN202011129781.6A patent/CN112190779A/en active Pending
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109260535A (en) * | 2018-09-10 | 2019-01-25 | 广州医科大学附属第医院 | A kind of CRRT pipeline replacing options |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| USRE38869E1 (en) | Extracorporeal circuit for peripheral vein fluid removal | |
| US4500309A (en) | Method for regional anticoagulation during extracorporeal dialysis | |
| US6685664B2 (en) | Method and apparatus for ultrafiltration utilizing a long peripheral access venous cannula for blood withdrawal | |
| US11918724B2 (en) | Method for temporarily interrupting an extracorporeal blood treatment, control device and blood treatment apparatus | |
| US20080004225A1 (en) | New dialysis method | |
| US5709993A (en) | Process for anticoagulation during extracorporeal blood circulation sequentially using citrate or nafamostat and heparin | |
| CN112190779A (en) | CRRT pipeline replacement method | |
| WO2018230577A1 (en) | Perfusion device and method for operating same | |
| US11819599B2 (en) | Extracorporeal blood circulation device | |
| Preuschof et al. | Heparin-free hemodialysis with prophylactic change of dialyser and blood lines | |
| JP4024506B2 (en) | Control method for anticancer drug perfusion apparatus | |
| US20100012588A1 (en) | system and method for the extra-corporeal purification of blood of pathogenic enzymes | |
| CN109260535A (en) | A kind of CRRT pipeline replacing options | |
| Vanholder et al. | Single needle haemodialysis | |
| CN204563087U (en) | The two-way blood back hemodialysis pipeline of not termination of pumping bridging closed arteriovenous | |
| CN213312291U (en) | Closed blood return machine | |
| CN219743509U (en) | Extracorporeal circulation pipeline of improved novel blood purification device | |
| EP4140517A1 (en) | Extracorporeal blood circuit for heparin-free haemodialysis | |
| Trakarnvanich et al. | The efficacy of single-needle versus double-needle hemodialysis in chronic renal failure | |
| CN211675610U (en) | Safe dialysis pipeline | |
| CN201752534U (en) | In-vitro blood circulating pipeline connecting apparatus | |
| CN117414488A (en) | Mixed type artificial liver double filtration adsorption plasma synthesis detoxification system and use method thereof | |
| CN203329102U (en) | Extracorporeal circulation blood circuit of heparin-free hematodialysis | |
| RU2155607C2 (en) | Method of correction of erythrocyte deformability | |
| CN113521418A (en) | Double-filtration adsorption plasma replacement system |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| RJ01 | Rejection of invention patent application after publication |
Application publication date: 20210108 |
|
| RJ01 | Rejection of invention patent application after publication |