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 Renal Replacement Therapy,and explore the clinical value of bedside ultrasound technique in acute kidney injury (AKI) Patients with continuous renal replacement therapy (CRRT) and capacity management. Methods 311 cases of AKI patients with CRRT were divided randomly into Observe group and Control group. the observe group was used bedside ultrasound technique, by monitoring tricuspid annular plane systolic excursion (TAPSE), internal diameter of inferior vena cava (IVC), respiratory variation index of the inferior vena cava internal diameter (RVI) and left vertical Tei index changes. Meanwhile, each parameter change was mediated by ultrasound detection from before, to 30min, 6h, 12h, 36h, 48h after of CRRT to sustain liquid balance in observe group, however, central venous pressure (CVP) change was modulated in control group. The difference of kidney length in pre-CRRT were examined to exclude, and of renal aortic diameter, renal resistance index (RRI)and renal blood flow in post-48h of CRRT were compared in two groups. Results Renal length, Renal parenchyma thickness and Echo strength of renal parenchyma weren't different statistically in pre-CRRT of two groups(P>0.05). In observe group, the RVI level was started to increase significantly and IVC internal diameter to decrease at 6h, which would tend to stable at 36h(F=27.746 and 15.446 respectively);the TAPSE level was gradual ascending and Tei index was descending at 12h with a stable tendency at 24h of CRRT(F=36.213 and 17.127 respectively), and there was difference statistical among time of obvious change in TAPSE, IVC internal diameter, RVI and Tei index(P<0.05);In control group, there was no difference statistical among each time in CVP(F=2.189, P>0.05). Compared with control group, renal aortic diameter and renal blood flow were increased significantly(t=2.356 and 2.075), RRI was decreased obviously in observe group(t=2.244), which was different in statistics (P<0.05). Conclusion the application of bedside ultrasound technique in AKI patient's capacity management with CRRT was more effective and evaluated the kidney perfusion.