An artery line is used to:
continuously measure blood pressure. The effect of medication and treatment can thus be measured accurately and the treatment can be adjusted if necessary.
to draw blood for testing. Usually, patients in the Intensive Care Unit require very frequent blood draws. This can then be done without having to prick the patient.
The artery line can be inserted in several places. Usually the artery in the wrist, upper arm or groin is chosen.
Kidney replacement therapies in the Intensive Care Unit
If the kidneys have suffered a lot of damage, they can temporarily no longer make urine
Intensive care Renal replacement therapy The human body gets rid of its waste products through the urine. Urine production takes place in the kidneys. In the urine you can find not only waste products, but also surpluses of minerals that the body no longer needs. If the kidneys no longer function properly (for example, due to damage as a result of low blood pressure as a result of blood poisoning, or as a result of drug use), these waste products accumulate in the body and can cause damage. The kidneys Most people have two kidneys, each located at the waist at the back of the body. The kidneys receive oxygenated blood from the renal artery, a branch of the large body artery (aorta). The kidney has three important functions: 1. To remove waste products. All kinds of substances are produced in the human body. Useful substances are created and waste products remain. The kidneys remove these wastes from the body. The kidneys make urine and the waste products are removed from the body with the urine. They also remove excess substances for the body, such as salts and acids. 2. Controlling the fluid balance. The human body consists of 80 percent water. The kidneys ensure that the composition of this water is as constant as possible. They drain the excess moisture. Together with the waste products, this fluid leaves the body as urine. 3. Making hormones. Hormones are substances that ensure that certain processes in the body run smoothly. The kidneys make a number of important hormones. These hormones are necessary for: – regulating blood pressure; – the calcium content in the blood; – the production of red blood cells
When renal replacement therapy? Patients with renal impairment often have no complaints in the beginning. As kidney function declines, they may develop problems with their fluid balance, resulting in fluid in the legs and behind the lungs. Sometimes blood tests and insufficient urine production show that the kidneys are not working properly. For example, potassium, a mineral normally excreted through the kidney, can build up in the body. However, potassium is also widely used by the heart. An excess of potassium can lead to cardiac arrhythmias. If the kidneys have suffered a lot of damage, they are temporarily unable to produce urine and the body can no longer get rid of waste. A choice can then be made to provide the patient with additional support by means of renal replacement therapy. In this way the body gets rid of its waste. This saves time to treat the underlying disease. Renal replacement therapy in the ICU Renal replacement therapy in the ICU is not the same as dialysis. With dialysis, kidney patients flush several times a week, for several hours. Fluid and waste products are removed from the body. With renal replacement therapy in the ICU, waste products and any fluid are removed from the body 24 hours a day. This treatment has less effect on blood pressure than dialysis. In certain situations this is important for a patient. How does renal replacement therapy work? First of all, of course, the patient’s blood will have to be fed to the machine. This requires a special line. The doctor inserts a dialysis catheter (a type of IV) into a large vein. This is usually in the groin, below the collarbone or in the neck. The catheter is inserted under local anaesthetic. Blood flows through the patient’s dialysis catheter to the device. The device will then check the composition of the blood and, if necessary, filter out the various waste products. In addition, the device can be set so that less blood is returned to the patient than is entering the device. In this way we can extract moisture, if necessary.
