Study and observation of ultrasound on hemorheology of continuous renal replacement therapy in ICU

Objective: To observe the influence of bedside ultrasound on Hemodynamics of Continuous \nRenal Replacement Therapy，and explore the clinical value of bedside ultrasound technique \nin acute kidney injury (AKI) Patients with continuous renal replacement therapy (CRRT) and \ncapacity management. Methods 311 cases of AKI patients with CRRT were divided randomly \ninto Observe group and Control group. the observe group was used bedside ultrasound \ntechnique, by monitoring tricuspid annular plane systolic excursion (TAPSE), internal diameter \nof inferior vena cava (IVC), respiratory variation index of the inferior vena cava internal \ndiameter (RVI) and left vertical Tei index changes. Meanwhile, each parameter change was \nmediated by ultrasound detection from before, to 30min, 6h, 12h, 36h, 48h after of CRRT to \nsustain liquid balance in observe group, however, central venous pressure (CVP) change was \nmodulated in control group. The difference of kidney length in pre-CRRT were examined \nto exclude, and of renal aortic diameter, renal resistance index (RRI)and renal blood flow in \npost-48h of CRRT were compared in two groups. Results Renal length, Renal parenchyma \nthickness and Echo strength of renal parenchyma weren’t different statistically in pre-CRRT \nof two groups(P＞0.05). In observe group, the RVI level was started to increase significantly \nand IVC internal diameter to decrease at 6h, which would tend to stable at 36h(F=27.746 and \n15.446 respectively); the TAPSE level was gradual ascending and Tei index was descending at \n12h with a stable tendency at 24h of CRRT(F=36.213 and 17.127 respectively), and there was \ndifference statistical among time of obvious change in TAPSE, IVC internal diameter, RVI and \nTei index(P＜0.05); In control group, there was no difference statistical among each time in \nCVP(F=2.189, P＞0.05). Compared with control group, renal aortic diameter and renal blood \nflow were increased significantly(t=2.356 and 2.075), RRI was decreased obviously in observe \ngroup(t=2.244), which was different in statistics (P＜0.05). Conclusion the application of \nbedside ultrasound technique in AKI patient’s capacity management with CRRT was more \neffective and evaluated the kidney perfusion.