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3 different types of acute failure have important significan

2017-02-02 15:52

The main points are as follows: 1. According to the history, detailed analysis, the specific content as mentioned above. It is important to identify the oliguria period according to the change of urine. The renogram examination: prerenal is a parabola, but after infusion can appear renal excretion; a low level graphics, no change after infusion; secretory period increased continuously after kidney, did not fall 15 minutes after rehydration does not change. It should be careful to distinguish the prerenal acute renal failure and ischemic acute renal tubular necrosis, the two are often similar to the etiology, insufficient blood volume, treatment sometimes opposite, such as the former should be in fluid expansion, the latter should be limited to water and sodium. In addition to the above specific method, can make the following 3 experiments: the fluid test: if within 1 hours, add 1000 ml of liquid, urine volume increased to 40 ml / hr for kidney before, if the blood volume has been corrected, no urine volume increased for renal tubular necrosis, the infusion should be discontinued immediately; mannitol test: if the test fluid not sure, at 5 ~ 15 minutes input 62.5 ~ 125 ml mannitol, average urine volume per hour within 2 hours was 40 ml for prerenal, or tubular necrosis, should be discontinued; furosemide test: blood volume corrected, urine volume is not increased, can the intravenous injection of 200 mg furosemide, urine volume increased within 2 h for kidney before, or not to increase again in 5% glucose 100 ml plus 500 mg 10 mg furosemide and dopamine, 1 hours after transfusion, urine volume increased prerenal, or tubular necrosis, should be discontinued . The above 3 tests should be carefully used, one should be prevented from water poisoning, caused by excessive expansion, left heart failure, after two may accelerate renal tubular necrosis, once found no response should be discontinued immediately. The above 3 methods are the methods to prevent the development of acute renal failure caused by acute renal failure. Related to the success or failure of the rescue.

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