Derivation and analysis of the theoretical model of hemodynamics in the extracorporeal circulation of CVVH mode

doi:10.3877/cma.j.issn.2096-1537.2020.04.014

Abstract

Abstract:

Objective

To better understand the operation and pressure information of CRRT by deducing the hemodynamic relationship in extracorporeal circulation of CVVH mode.

Methods

It was divided into three dilution modes and four parts in CVVH mode. The mathematical formulas were developed based on Ohm law, Poiseuille law and the physiology of GFR.

Results

1．In Filter part, the pressure difference between the pre-Filter and post-Filter is determined by the resistance and flow of Filter. 2. In Filtermembrane part: TMP is determined by the value of filtration, the area and the permeability of the membrane, and the colloid osmotic pressure in Filter. 3. In Venous-chamber and Venous-catheter part: the Post-Filter pressure is a reflection of total resistance of chamber and catheter.

Conclusion

The hemodynamic relationship in extracorporeal circulation of CVVH mode could be analyzed more clearly with the mathematical models.

Key words: CRRT, CVVH, Ohm law, Poiseuille law, Alarm message of CRRT

Yunzhen Wu. Derivation and analysis of the theoretical model of hemodynamics in the extracorporeal circulation of CVVH mode[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(04): 431-438.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2020.04.014

https://icu.cma-cmc.com.cn/EN/Y2020/V06/I04/431

Figures/Tables 5

部位	模式	$Δ P$
滤器	前置换	$P 滤器前 - P 滤器后 = 2 Q 血 + Q 前置换 - Q 脱水 2 8 × 12 η 血 Q 血 Q 血 + Q 前置换 + Q 血 Q 血 - Q 脱水 L 滤器 π r 1 4 + r 2 4 … + r n 4$
	后置换	$P 滤器前 - P 滤器后 = 2 Q 血 - Q 后置换 - Q 脱水 2 8 × 12 η 血 1 + Q 血 Q 血 - Q 后置换 - Q 脱水 L 滤器 π r 1 4 + r 2 4 … + r n 4$
	前后联合置换	$P 滤器前 - P 滤器后 = 2 Q 血 + Q 前置换 - Q 后置换 - Q 脱水 2 8 × 12 η 血 Q 血 Q 血 + Q 前置换 + Q 血 Q 血 - Q 后置换 - Q 脱水 L 滤器 π r 1 4 + r 2 4 … + r n 4$
滤膜	前置换	$T M P = P 滤器前 + P 滤器后 2 - P 滤液 = Q 前置换 + Q 脱水 K 滤膜 S 滤膜 + 12 П 血 Q 血 Q 血 + Q 前置换 + Q 血 Q 血 - Q 脱水$
	后置换	$T M P = P 滤器前 + P 滤器后 2 - P 滤液 = Q 后置换 + Q 脱水 K 滤膜 S 滤膜 + 12 П 血 1 + Q 血 Q 血 - Q 后置换 - Q 脱水$
	前后联合置换	$T M P = P 滤器前 + P 滤器后 2 - P 滤液 = Q 前置换 + Q 后置换 + Q 脱水 K 滤膜 S 滤膜 + 12 П 血 Q 血 Q 血 + Q 前置换 + Q 血 Q 血 - Q 后置换 - Q 脱水$
静脉壶 - 静脉导管	前置换	$P 滤器后 - P 导管后 = Q 血 - Q 脱水 R 壶 - 导管$
	后置换	$P 滤器后 - P 导管后 = Q 血 - Q 脱水 R 壶 - 导管$
	前后联合置换	$P 滤器后 - P 导管后 = Q 血 - Q 脱水 R 壶 - 导管$

部位	模式	$Δ P$
滤器	前置换	$P 滤器前 - P 滤器后 = 2 Q 血 + Q 前置换 - Q 脱水 2 8 × 12 η 血 Q 血 Q 血 + Q 前置换 + Q 血 Q 血 - Q 脱水 L 滤器 π r 1 4 + r 2 4 … + r n 4$
	后置换	$P 滤器前 - P 滤器后 = 2 Q 血 - Q 后置换 - Q 脱水 2 8 × 12 η 血 1 + Q 血 Q 血 - Q 后置换 - Q 脱水 L 滤器 π r 1 4 + r 2 4 … + r n 4$
	前后联合置换	$P 滤器前 - P 滤器后 = 2 Q 血 + Q 前置换 - Q 后置换 - Q 脱水 2 8 × 12 η 血 Q 血 Q 血 + Q 前置换 + Q 血 Q 血 - Q 后置换 - Q 脱水 L 滤器 π r 1 4 + r 2 4 … + r n 4$
滤膜	前置换	$T M P = P 滤器前 + P 滤器后 2 - P 滤液 = Q 前置换 + Q 脱水 K 滤膜 S 滤膜 + 12 П 血 Q 血 Q 血 + Q 前置换 + Q 血 Q 血 - Q 脱水$
	后置换	$T M P = P 滤器前 + P 滤器后 2 - P 滤液 = Q 后置换 + Q 脱水 K 滤膜 S 滤膜 + 12 П 血 1 + Q 血 Q 血 - Q 后置换 - Q 脱水$
	前后联合置换	$T M P = P 滤器前 + P 滤器后 2 - P 滤液 = Q 前置换 + Q 后置换 + Q 脱水 K 滤膜 S 滤膜 + 12 П 血 Q 血 Q 血 + Q 前置换 + Q 血 Q 血 - Q 后置换 - Q 脱水$
静脉壶 - 静脉导管	前置换	$P 滤器后 - P 导管后 = Q 血 - Q 脱水 R 壶 - 导管$
	后置换	$P 滤器后 - P 导管后 = Q 血 - Q 脱水 R 壶 - 导管$
	前后联合置换	$P 滤器后 - P 导管后 = Q 血 - Q 脱水 R 壶 - 导管$

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