Objective To observe the application effect of three-level precision volume management in continuous renal replacement therapy(CRRT)for critically ill patients.Methods A total of 156 patients who underwent CRRT treatment in the emergency intensive care unit(EICU)of our hospital from January 2020 to January 2022 were selected.The patients were divided into the observation group and the control group with 78 cases in each group by random number.In the observation group,three-level refined volume management was performed during CRRT treatment,where doctors selected appropriate hemodynamic monitoring methods to evaluate the patient's volume status,set safe volume values and hourly liquid balance targets for CRRT treatment,and whether the volume index touched the upper or lower limit of the volume safety value was closely observed.The fluid balance target and the net dehydration rate of CRRT treatment were dynamically adjusted.In the control group,conventional volume management was performed during the treatment of CRRT,that is,the overall goal of fluid balance during the treatment cycle was set according to the volume status of the patients,and the net dehydration rate was set according to the total intake and outflow of the patients during the treatment cycle.Results There was no significant statistical difference between the two groups in terms of mechanical ventilation time and EICU stay time(P>0.05).Compared with the control group,the observation group had fewer days of vasopressor use during CRRT(P<0.05)and fewer days of required CRRT treatment(P<0.05).On the fifth day of treatment,both central venous pressure and blood lactate values of the observation group were significantly lower than those of the control group(P<0.05),and the mean arterial pressure was significantly higher than that of the control group(P<0.05).Conclusion Although the three-level precision volume management plan does not reduce the number of EICU stay days,it helps to quickly correct the shock state of CRRT patients and reduced the treatment time of CRRT.This results in a reduction in the treatment cost of CRRT for critically ill patients,indicating potential for clinical promotion.
Volume managementContinuous renal replacement therapyIntensive care unit
万方数据
维普
