Transcript 2-1 اندیکاسیونهای دیالیز حاد و مزمن

‫دانشگاه علوم پزشكي و خدمات بهداشتي‬
‫درماني استان فارس‬
‫معاونت درمان‬
‫اداره امور بيماريهاي خاص‬
‫دكترمحمدرضا مرواريدي‬
‫كارشناس اداره امور بيماريهاي خاص‬
Severe fluid overload
Refractory hypertension
Uncontrollable hyperkalemia
Nausea, vomiting, poor appetite, gastritis with hemorrhage
Lethargy, malaise, somnolence, stupor, coma, delirium,
asterixis, tremor, seizures,
Pericarditis (risk of hemorrhage or tamponade)
bleeding diathesis (epistaxis, gastrointestinal (GI) bleeding
and etc.)
Severe metabolic acidosis
Blood urea nitrogen (BUN) > 70 – 100 mg/dl
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Pericarditis
Fluid overload or pulmonary edema refractory to
diuretics
Accelerated hypertension poorly responsive to
antihypertensives
Progressive uremic encephalopathy or neuropathy
such as confusion, asterixis, myoclonus, wrist or
foot drop, seizures
Bleeding diathesis attributable to uremia
AEIOU
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Acidosis (metabolic)
Electrolytes (hyperkalemia)
Ingestion of drugs/Ischemia
Overload (fluid)
Uremia
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Calcium gluconate (carbonate)
Sodium Bicarbonate
Insulin/glucose
Kayexalate
Lasix
Albuterol
Hemodialysis
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Weakness
Lethargy
Muscle cramps
Paresthesias
Hypoactive DTRs
Dysrhythmias
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K > 5.5 -6
Tall, peaked T’s
Wide QRS
Prolong PR
Diminished P
Prolonged QT
QRS-T merge – sine
wave