Haemodialysis in children.ppt

7/23/2019 Haemodialysis in children.ppt

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Almtgmts

Kmtrlhuatklm

Kmhkantklms lchkniysks

Aflkag lc hkniysks

Zghkntrkafg`lhkniysks

Snsauinr naagss Gxtrnalrplrgni

akraukt

Hkniysntg

Hkniysks

`nafkmgNmtkalneuintklm

Al`pikantklm

Almaiusklms _gcgrgmags


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Ufy n kmcnmt mgghs hkniysks


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Hgvgilp`gmt lc dkhmgy Xfg mgw olrm dkhmgy ks k``nturg nmh almtnkms

lmiy >5' lc agiis clumh km nm nhuit dkhmgy

Xfg rg`nkmhgr lc tfg agiis hgvgilp oy skx`lmtfs lc neg

Xfg eil`gruinr ckitrntklm rntg &EC_+ nt okrtfnvgrnegs lmiy nolut ?:`i,`km,>51`?

Kt kmargnsgs tl 6:`i,`km,>51`?)oy skx `lmtfs

Nt neg nmh rgnafgs tfg mlr`ni nhuit rntg km tfg

?mh ygnr lc ikcg


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Nautg hkniysks kmhkantklms

Likeurkn&:3`i,de,fr+

Fypl pgrcusklm

Eil`gruilrmgpfrktks Mgpfrltlxka plkslms

Wrg`ka pgrkanrhktks

Fypgrdnig`kn


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Afrlmka rgmni cnkiurg

Eil`gruinr hksgnsg 0 18'

@niclr`ntklm lc urkmnry trnad 0 ??'

Fgrghktnry &trnms`kttgh crl` pnrgmts+ 0 >3'

Hyspinskn&nomlr`ni hgvgilp`gmt lc rgmni tkssug +>>'

Wmagrtnkm 0 7'

Ltfgrs 0 >?'


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Aflkag lc hkniysks


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ZG_KXLMGNI HKNI[QKQ

pgrktlmgni hkniysks ks tfg ckrst trgnt`gmtlcaflkag km kmcnmts

Oganusg kts fnvg `nmy nhvnmtnegs tfnm

ltfgrs Ml mggh clr vnsauinr naagss) oillh

prk`kme) nmtkalneuintklm) gxt

Mglmntni fns n pgrktlmgni surcnag nrgnni`lst twkag tfnt lc tfg nhuit wfgm pgrktlmgni hkniysks sfluih og twkag ns

gcckakgmt km tfg mglmntni%


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almtkmulus rgmni rgpinag`gmttfgrnpy

A__X ks usgh ni`lst

gxaiuskvgiy km tfg

kmtgmskvg anrgsgttkme

lmiy

Ql kts mlt almvgmkgmt clr

afrlmka LZ pntkgmts

Km Nautg Zntkgmts kt `ny

og ld
http://en.wikipedia.org/wiki/Intensive_carehttp://en.wikipedia.org/wiki/Intensive_care


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Fng`lhkniysks

Fg`lhkniysks kspgrclr`gh wfgmpgrktlmgni hkniysks ks

almtrnkmhkantghoganusg lc nm kmtrn-nohl`kmni prlagss&kmaiuhkme rgagmtnohl`kmni suregry)

hknpfrne`ntka fgrmkn)lr rgspkrntlry ik`ktntklm+

NENKMQX

Xgafmkaniiy hkcckauit kmtfg vgry s`nii

Mggh clr nmtkalneuintklm

Mlt n almtkmulus`lhnikty ciukhs nmhmutrktklm mggh tl og

rgstrkatgh Mlt suktnoig clr

fng`lhymn`kaniiumstnoig


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Snsauinr naagss

Snsauinr naagss rg`nkms n `nblr

ik`ktntklm tl suaagsscui fg`lhkniysks km

s`nii afkihrgm Zinakme nmh `nkmtnkmkme

pgr`nmgmt naagssgs km s`nii vgssgis

rgqukrgs gxpgrkgmagh nmh hghkantgh

sureglms nmh rnhklileksts Snsauinr

antfgtgrs anm og pinagh oy kmtgrvgmtklmnirnhklileksts lr sureglms hgpgmhkme lm

tfg ogst gxpgrkgmag nvnkinoig km nm

kmstktutklm


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Antfgtgrs

Nvnkinoig hluoig-iu`gm fg`lhkniysks

antfgtgrs rnmeg crl` 1 C tl >? C km igmetfs

npprlprkntg clr s`nii afkihrgm tg`plrnry nmh

pgr`nmgmt antfgtgrs nrg nvnkinoig) nmh Xfgantfgtgr tkp sfluih og rnhklilekaniiy

plsktklmgh km tfg bumatklm lc tfg supgrklr

vgmn anvn nmh rkeft ntrku`

Km s`nii kmcnmts nmh mglmntgs) skmeig-iu`gm

antfgtgrs `ny og `lrg npprlprkntg

almskhgrkme vgssgi skzg


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Flw tl hgakhg antfgtgr skzg

Zntkgmt skzg

&de+

Antfgtgr skzg

9 >: 1 XL 6 Cr huni iu`gm

>:-?: 6 Cr huni iu`gm

?:-8: >: Cr huni iu`gm= 8: >>7 lr >?7 Cr huni

iu`gm


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Ckstuins nmh erncts

Km lihgr afkihrgm) argntklm lc nm nrtgrklvgmlus ckstuin ogtwggmtfg rnhkni nrtgry nmh agpfnika vgkm km tfg gmh-tl-skhgnmnstl`lsks ks n al``lm lhg lc vnsauinr naagss

Ufgm oillh vgssgi skzg ks tll s`nii clr almstruatkme nmnhgquntg ckstuin) n pliytgtrnciulrlgtfyigmg &ElrgXgx lr K`prn+ernct anm og pinagh ogtwggm nm gxtrg`kty nrtgry nmh vgkm

Anmmuintklm ks vgry hkcckauit oganusg lc vgrys`nii vgkm sl wg mggh pntkgmts allpgrntklm

Xl nvlkh pnkm usg Nmgstfgtka sprny nvlkhs`nii mgghikme nisl)))))


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Oillh cilw nmh hkniysntg cilw

Hgskrgh oillh cilw rntg ks tnregtgh tl urgn

aignrnmag spgakckantklms clr n aflsgm

hkniyzgr nm kmktkni urgn aignrnmag lc1 Ì

pgr kmutg pgr de ks pruhgmt tl nvlkh

sy`ptl`ntka hksgqukikorku`

Xypkaniiy km tfg rnmeg lc 7:ì tl >7: Ì pgr

`kmutg km s`nii afkihrgm nmh ?::ì tl 17:

Ì pgr `kmutg km lihgr afkihrgm Q`nii

antfgtgrs lctgm ik`kt cilw tl ?7ì tl >:: Ìpgr `kmutg oganusg lc ik`ktgh nrtgrkni kmcilw

Hkniysntg cilw tl og dgpt nt 8::-7:: ì,`km

Hlgs mlt hgpgmh lm skzg lc afkih


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Gxtrn alrplrni akraukt

N egmgrniiy naagptgh ruig clr kmcnmt

hkniysks ks tfnt tfg gxtrn alrplrni oillh

vliu`g sfluih mlt gxaggh >:' lc tltni

oillh vliu`g

Xfks ks aniauintgh uskme tfks clr`uin

&oillh vliu`g06:`i,de+


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Clr gxn`pig

?:de afkih " 6:ì 0>3::ì

>:'lc >3:: 0 >3:ì

Xfgrgclrg >3:ì ks tfg tltni oillhvliu`g tfnt sfluih og km tfg Gxtrnalrplrni akraukt hurkme fg`lhkniysks

Kc tfg vliu`g ks gxagghgh hkniyzgr #oillhikmg prk`gh wktf oillh lrniou`km sliutklm


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Zinmmkme WC

Elni tl prl`ltg ciukh rg`lvni wfkig

`nkmtnkmkme fg`lhymn`ka stnokikty

tfrlueflut trgnt`gmtNosliutgiy gssgmtkni gstk`ntg lc hry

wgkeft $ naaurntg `gnsurg`gmt lc

aurrgmt wgkeft WC rg`lvni km n skmeig sgssklm sfluih

mlt gxaggh 7' lc olhy wgkeft lr :?

`i,de,`km tl nvlkh akrauintlry aliinpsg


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Hkniyzgr

Hkniyzgr afnrnatgrkstkas

- surcnag nrgn sfluih mlt gxaggh afkihs

OQN

- s`nii prk`kme vliu`g

- urgn aignrnmag 1-7 `i,de,`km

- symtfgtka lvgr agiiuilsg onsgh`g`ornmgs


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Nvnkinoig Hkniyzgrs

Hkniyzgr Zrk`kme

vliu`g&

ì+

Qurcnag

nrgn &`?+

`gòrnmg `nmucnatu

rg

>::FE >6 :? Fg`lpfnm Enòrl

Qurgciux-1:i

&7:i+&5:i+

?7&17+&87

+

:1&:7+&:5+Xrknagtntg Mkprl

CO-

7:X&5:X+&;:X+

17&87+&77

+

:7&:5+&:;+ Hknagtntg Mkprl

C1C8C8: ?6&8?+&8?

+

:8&:5+&:5+ pliysliclmg Crgsgmkus

AN7:&5:+ 17&87+ :7&:5+ Agiiuilsg

nagtntg

Onxtgr


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Aignrnmag Hgpgmhs lm

- Oillh cilw

- Hkniysntg cilw- Hkniyzgr surcnag nrgn

- Hkniyzgr pgr`gnokikty

Nk` clr urgn aignrnmag lc >`i,de,`km kmkmktkni hkniysks sgssklms nmh ernhuniiy

kmargnsg uptl 8 `i,de,`km


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Oillh Xuokme

Npprlprkntgiy skzgh oillh ikmgs niilw almtrlilc akraukt vliu`g Kc tfg vliu`g lc tfg gmtkrggxtrnalrplrgni akraukt gxagghs >:' lc tfg

pntkgmt%s oillh vliu`g &=6 Ì,de+) nwnr`gh oillh &lr niou`km+ prk`g ks usuniiyekvgm tl gmsurg fg`lhymn`ka stnokikty

Oillh ikmgs nrg nvnkinoig km n rnmeg lcskzgs2 Mglmntni &~?: Ì+) kmcnmt &~8: Ì+)

nmh pghkntrka &~5: Ì+ Kt ks k`plrtnmt tfnttfg oillh pu`p og prlpgriy anikorntgh clrtfg aflsgm oillh ikmgs


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Nvnkinoig tuokme

Mn`g lc tfg

oillh ikmgs

Nrtgry

vliu`g&ì+

Sgmus

vliu`

g &ì+

Xltni-

vliu`g&ì+

`nmucnatur

gr

N-135n1

S-8>8nx

>? ?> 11 Enòrl

Q-71:66

S-1:6;

?6 ?? 7: anrhklvksklm

Os`?

N13p-pv5

157 1:7 36 flspni


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Hkniysntg

Okanrolmntg hkniysks sliutklm ks stnmhnrh

clr pghkntrka fg`lhkniysks4 kt prlvkhgs

ogttgr fg`lhymn`ka stnokikty nmh cgwgr

kmtrnhkniytka sy`ptl`s Zntkgmts wktf

s`nii `usaig `nss wkii og umnoig tl

`gtnolikzg n inreg nagtntg ilnh qukadiy


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Hkniysks `nafkmgs

Hkniysks `nafkmgs tfnt prlvkhg vliu`gtrka

uitrnckitrntklm almtrli nrg rgqukrgh Q`nii

grrlrs km uitrnckitrntklm vliu`g &lc n cgw

fumhrgh `kiikiktgrs+ `ny anusg sy`ptl`ntkafypltgmsklm lr afrlmka vliu`g lvgrilnh

Oillh cilws `ust og naaurntg wktfkm tfg

rnmeg lc 1: tl 1:: `I pgr `kmutg nmh tfg

oillh pu`p anikorntgh tl hkccgrgmt skzg ikmgs


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NmtkalneuintklmQtnmhnrh fgpnrkmksntklm

Zntkgmts wgkeft&de+

Kmktkni olius &Wmkts lcfgpnrkm,de+

7->7 >:->3

>7-?7 >3-?:

?7-17 >6-?:

17-77 >6-?:= 77 ?:

Kmcusklm hurkme hkniysks 0 >7-?: Wmkts,de,fr


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Clr nii wgkefts al``lmiy

wg nrg uskme stnmhnrh fgpnrkm hlsgs

clr pghkntrka pntkgmts tfnt ks

Qystg`ka 0 57:ku olius 7::ku,fr`nkmtgmnmag

_kekh0 7::ku olius ?7:ku,fr

`nkmtgmnmag


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Fgpnrkm crgg hkniysks

Nvlkhkme ailttkme lc tfg akraukt 4 ciusf

wktf mlr`ni snikmg gvgry 1: `kmutgs

- Ugkeft 9 ?: de ?7 `i lc mlr`ni snikmg

- Ugkeft = ?: de 7: `i lc mlr`ni snikmg

Nhh tfks vliu`g tl mgt uitrnckitrntklm

tnregt


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Oillh sn`pikme Xfg silw-cilw tgafmkqug clr oillh sn`pikme ks

k`plrtnmt clr naaurntg `gnsurg`gmt

Zghkntrka oillh ikmgs anm og nhgquntgiy

aignrgh oy n silw-cilw rntg &3: `I pgr`kmutg+ clr >5 sgalmhs4

wg prghkat kmcnmt ikmgs wkii rgqukrg >?

sgalmhs nt n silw-cilw rntg lc ?: `I pgr`kmutg Xfg ergntgr rgiknmag lm antfgtgrs km

pghkntrka hkniysks rnksgs almagrm tfnt

rgakrauintklm wkii hk`kmksf trgnt`gmt gcckakgmay


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al`pikantklm Lurs`nii `kstndgs wkii ekvg n oke

al`pikantklm clr kmcnmts

Nii nhuit al`pikantklms &ikdg nkr g`oliks` #

`nafkmg grrlrs+ nrg sn`g out ltfgr

k`plrtnmt al`pikantklms mggh hksaussklm


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Hksgqukikorku` symhrl`g

Qn`g ikdg nhuits out

fgnr fnppgm `lrg

Q`nii ornkm tkssugs

urgn trnmscgrs `lrgsilwiy tl tfg oillh sl

ciukh ks hrnwm km tl tfg

ornkm gnskiy kt anusgs

swgiikme Ql urgn aignrnmag

sfluih og 1`i,`km


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Fypltgmsklm

Kmtrnhkniytka fypltgmsklm nmh arn`pkme wktfciukh rg`lvni =7' lc olhy wgkeft nrg

al``lm

Sliu`g rg`lvni `ust og ailsgiy `lmktlrgh

oganusg oillh prgssurg ks mlr`niiy ilwgr km

afkihrgm tfnm km nhuits

Wsg sgpnrntg pghkntrka OZ nppnrntus clrkmcnmts clr naaurntg `gnsurg`gmt lc OZ

oillh &lr niou`km+ prk`g ks usuniiy ekvgm tl

gmsurg fg`lhymn`ka stnokikty


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Qupplrt tfgrnpkgs

Ekvg Grytfrlplkgtkm Xfgrnpy clr Nmg`kn

Ekvg _gal`okmnmt Fu`nm Erlwtf

Flr`lmg &rfEF+ Xfgrnpy clr erlwtf

Sktn`km H Xfgrnpy clr _gmni

Lstglhystrlpntfy

Ziny Xfgrnpy clr r_gfnokiktntklm


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_gcgrgmag

Fnmh olld lc hkniysks - Blfm X Hnuekrhns

@H -?::5 4 3:3-3?7

_gmni Murskme_logrt Wihnii @H C_AZ>;664 1?:-1?5

Afkihrgm wktf dkhmgy hksgnsgs Qg`km mgpfrli

-?::34371-376

wgo rgcgrgmag2 wwwfhamal`

wwwdkhmgylre

wwwparrtal`
http://www.hdcn.com/http://www.kidney.org/http://www.pcrrt.com/http://www.pcrrt.com/http://www.kidney.org/http://www.hdcn.com/


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Haemodialysis in children.ppt