血液滤过操作简介血液滤过操作简介ContinuousVeno-venousHemofiltration(CVVH)河北医科大学第三医院河北医科大学第三医院- -急诊科急诊科郝广卉郝广卉主要内容主要内容一、认识血滤机及各部件一、认识血滤机及各部件二、操作简要流程二、操作简要流程1. 1.准备用物准备用物2.2.开机自检开机自检3.3.安装管路安装管路4.4.预冲预冲5.5.压力测试压力测试6.6.闭路循环闭路循环7.7.参数设置参数设置8.8.连接病人连接病人9.9.治疗阶段治疗阶段10.10.回血下机回血下机11.11.用物处理用物处理第一部分第一部分认识血滤机认识血滤机显示屏滤器前压力传感器血泵滤出液泵滤出液压力传感器滤器静脉压力传感器动脉压力传感器滤出液秤后置换泵前置换泵空气探测器除气壶静脉夹肝素泵置换液秤漏血壶加热器1.绿灯：治疗正在进行中，系统没有出现任何报警的情况。2.黄灯：系统正处于准备状态或者是重复循环或者是连接病人的操作模式或者加热器在自检。3.红灯：系统出现故障或者是系统出现错误操作状态显示主旋钮静音键静脉夹键平衡键血泵键第二部分第二部分操作操作流程流程1. 1.准备用物准备用物2.2.开机自检开机自检3.3.安装管路安装管路4.4.预冲预冲5.5.压力测试压力测试6.6.闭路循环闭路循环7.7.参数设置参数设置8.8.连接病人连接病人9.9.治疗阶段治疗阶段10.10.回血下机回血下机11.11.用物处理用物处理AquariusAquarius管路与滤器管路与滤器肝素生理盐水肝素生理盐水纯生理盐水纯生理盐水置换液置换液20ml 20ml 注射器注射器第二部分第二部分操作操作流程流程1. 1.准备用物准备用物2.2.开机自检开机自检3.3.安装管路安装管路4.4.预冲预冲5.5.压力测试压力测试6.6.闭路循环闭路循环7.7.参数设置参数设置8.8.连接病人连接病人9.9.治疗阶段治疗阶段10.10.回血下机回血下机11.11.用物处理用物处理SystemtestSystemtestrunningrunningMaster:6.00.00Video:V6.00.00Text version 6.00.00errtxt 6.00.0Modetxt 6.00.00SCUFSCUFCVVHCVVHCVVHDCVVHDCVVHDFCVVHDFHEMOPERFUSIONHEMOPERFUSIONTPETPESelecttherapySelecttherapyContinuousveno-venoushemofiltration连续性静静脉血液滤过连续性静静脉血液滤过HelpHelpSlowcontinuousultrafiltration缓慢连续性超滤缓慢连续性超滤SCUFSCUFCVVHCVVHCVVHDCVVHDCVVHDFCVVHDFHEMOPERFUSIONHEMOPERFUSIONTPETPESelecttherapyHelpHelpcontinuousveno-venoushemodialysis连续性静连续性静- -静脉血液透析静脉血液透析SCUFSCUFCVVHCVVHCVVHDCVVHDCVVHDFCVVHDFHEMOPERFUSIONHEMOPERFUSIONTPETPESelecttherapyHelpHelpcontinuousveno-venoushemodiafiltration连续性静连续性静- -静脉血液透析滤过静脉血液透析滤过SCUFSCUFCVVHCVVHCVVHDCVVHDCVVHDFCVVHDFHEMOPERFUSIONHEMOPERFUSIONTPETPESelecttherapyHelpHelpHemoperfusion血液灌流血液灌流SCUFSCUFCVVHCVVHCVVHDCVVHDCVVHDFCVVHDFHEMOPERFUSIONHEMOPERFUSIONTPETPESelecttherapyHelpHelpplasmaexchange血浆置换血浆置换SCUFSCUFCVVHCVVHCVVHDCVVHDCVVHDFCVVHDFHEMOPERFUSIONHEMOPERFUSIONTPETPESelecttherapyHelpHelpSelectaqualineforadulttreatmentBloodflow30to450ml/min请选择成人治疗管路，可供血流速为30-450ml/minAqualinesforAqualinesforpediatrictreatmentpediatrictreatmentCVVHCVVHAdultAqualineAdultAqualinePreparationPreparationPreviousPreviousZoomgraphicZoomgraphicAqualineforAqualineforadulttreatmentadulttreatmentSelectkindoflineSelectkindoflinetobeusedtobeusedforthistreatmentforthistreatmentHelpHelpADULTTREATMENTYouhaveselectedaqualinetubingsetforADULTtreatment.Bloodflow30to450ml/minUseofanaqualinedifferenttothatselectedon-screenwillcreateanalarmduringpriming.Checkthelineandthenproceed.Yes-nextstepNo-previousstepYesYesCVVHCVVHAdultAqualineAdultAqualineConfirmwindowConfirmwindowNoNoAccess -13 mmHg-250 200-80 300-150 200-50 450Return 0 mmHgTMP 19 mmHgPr.Drop 30 mmHgBloodflowBloodflowml/minml/min80成人治疗成人治疗您选择了供成人治疗的管路集合您选择了供成人治疗的管路集合血流速可为血流速可为30-450ml/min30-450ml/min应用与屏幕显示种类不同的管路将会导致在预冲应用与屏幕显示种类不同的管路将会导致在预冲过程中报警过程中报警核对管路类型之后继续核对管路类型之后继续YesYes下一步下一步No-No-返回上一步返回上一步YesYesCVVHCVVHAdultAqualineAdultAqualineConfirmwindowConfirmwindowNoNoAccess -13 mmHg-250 200-80 300-150 200-50 450Return 0 mmHgTMP 19 mmHgPr.Drop 30 mmHgBloodflowBloodflowml/minml/min80CVVHCVVHAdultAqualineAdultAqualinePreparationPreparationPreviousPreviousZoomgraphicZoomgraphicNextNextInsertcassetteInsertcassettesystemandbagssystemandbagsClosepumpdoorsClosepumpdoorsHelpHelp第二部分第二部分操作流程操作流程1. 1.准备用物准备用物2.2.开机自检开机自检3.3.安装管路安装管路4.4.预冲预冲5.5.压力测试压力测试6.6.闭路循环闭路循环7.7.参数设置参数设置8.8.连接病人连接病人9.9.治疗阶段治疗阶段10.10.回血下机回血下机11.11.用物处理用物处理Pre-filter pressure Pre-filter pressure sensorsensorReturn pressure Return pressure sensorsensorAccess pressure Access pressure sensorsensorFiltrate pressure Filtrate pressure sensorsensor除气壶除气壶空气探测器空气探测器静脉夹静脉夹CVVHCVVHAdultAqualineAdultAqualinePreparationPreparationPreviousPreviousZoomgraphicZoomgraphicNextNextInsertcassetteInsertcassettesystemandbagssystemandbagsClosepumpdoorsClosepumpdoorsHelpHelpCVVHCVVHAdultAqualineAdultAqualinePreparationPreparationPreviousPreviousNoanticoagulantNoanticoagulantPreparesyringePreparesyringePreparePrepareanticoagulantanticoagulantHelpHelpCVVHCVVHAdultAqualineAdultAqualinePreparationPreparationPrepareancoagulantPrepareancoagulantStartprimingStartprimingCheckalllinesCheckalllinesOpenallclampsOpenallclampsStartprimingStartprimingHelpHelpBloodflowBloodflowml/minml/min80第二部分第二部分操作简介操作简介1. 1.准备用物准备用物2.2.开机自检开机自检3.3.安装管路安装管路4.4.预冲预冲5.5.压力测试压力测试6.6.闭路循环闭路循环7.7.参数设置参数设置8.8.连接病人连接病人9.9.治疗阶段治疗阶段10.10.回血下机回血下机11.11.用物处理用物处理ReprimeReprimeCVVHCVVHAdultAqualineAdultAqualinePrimingPrimingcompletedcompletedNextNextAccess 48 mmHg-250 200-80 300-150 200Return 57 mmHgTMP 28 mmHgBloodflowBloodflowml/minml/min150BloodcircuitBloodcircuitPostdilutionlinePostdilutionlinepredilutionlinepredilutionlineFiltratelineFiltratelineHelpHelp第二部分第二部分操作流程操作流程1. 1.准备用物准备用物2.2.开机自检开机自检3.3.安装管路安装管路4.4.预冲预冲5.5.压力测试压力测试6.6.闭路循环闭路循环7.7.参数设置参数设置8.8.连接病人连接病人9.9.治疗阶段治疗阶段10.10.回血下机回血下机11.11.用物处理用物处理Gotoclamp&pressuretestIMPORTANTForclamp&pressuretestyouhavetoconnectthereturnandaccesslinestoonesalinesolutionbagbeforeyouconfirm“yes”.Makesurethatairdetectionisoperational(airdetectionkeyhasstaticgreenlight)beforeconfirming“yes”Afterstartingbloodpump,thesalinesolutioniscirculatedthroughthefilterandthetestisconducted.YesYesCVVHCVVHAdultA