RRT

Question 1

indications for dialysis

Answer 1

• refractory acidosis
• Electrolyte (hyper K)
• Ingestion of poisons
• Overload
• Uremia

Question 2

SCUF

Answer 2

• slow continuous ultrafiltration
• primary goal: fluid removal via ultrafiltration
• no dialysate, no replacement fluids
• used patients unresponsive to diuretics
• not used for patients with acidosis problems or hyper K

Question 3

CVVH

Answer 3

• continuous veno-venous hemofiltration
• all convective therapy
• fluid and solute removal, removing at much high rate
• ## requires replacement solution to drive convection , no dialysate

Question 4

CVVHD

Answer 4

• continuous veno-venous hemodialysis
• convection and diffusion ( slow HD)
• primary goal: solute removal by diffusion, safe fluid volume management
• requires dialysate solution
• dialysate flow rate= 15-45ml/min
• no replacement solution
• solute removal determined by dialysate flow rate

Question 5

CVVHDF

Answer 5

• continuous veno-venous hemodiafiltration
• high dose of convection
• same as CVVHD plus convection
• primary goal: solute removal by diffusion and convection, safe dluid removal management
• uses dialysate solution
• dialysate flow rate= 15-45ml/min

Question 6

Diffusion

Answer 6

• movement of solute down concentration gradient
• influenced by dialysate, surface area
• movement of solute from an area of high concentration to an area of lower concentration
• dialysate is used to create a concentration gradient across a semipermeable membrane
• Dialysis used a semipermeable membrane for selected diffusion

Question 7

Convection

Answer 7

Movement of solutes with water flow “solvent drag”

• the more fluid moved through a semipermeable membrane, the more solutes are removed
• most important for middle molecules
• depending on UF up to 20% of small solute clearance in typical rx
• convection clearance depends on pathway of water movement from blood side to dialysate side
• driving force: transmembrane pressure

Question 8

Ultrafiltration

Answer 8

• movement of fluid through a semipermeable membrane caused by a pressure gradient
• positive, negative and osmotic pressure from non-permeable solutes
• the movement of fluid through a membrane caused by a pressure gradient