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https://www.readbyqxmd.com/read/28729905/an69st-membranes-adsorb-nafamostat-mesylate-and-affect-the-management-of-anticoagulant-therapy-a-retrospective-study
#1
Takahiro Hirayama, Nobuyuki Nosaka, Yasumasa Okawa, Soichiro Ushio, Yoshihisa Kitamura, Toshiaki Sendo, Toyomu Ugawa, Atsunori Nakao
BACKGROUND: In Japan, nafamostat mesylate (NM) is frequently used as an anticoagulant during continuous renal replacement therapy (CRRT). The dialyzer membrane AN69ST has been reported to adsorb NM and affect the management of anticoagulant therapy. However, the adsorbed amount has not yet been quantitatively assessed. Therefore, in this study, we evaluated the pre- and post-hemofilter prolongation of the activated clotting time (ACT) in patients with AN69ST and PS membranes. We also measured the adsorption of NM in three types of CRRT membranes using an experimental model...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28701841/continuous-renal-replacement-therapy-applications-on-extracorporeal-membrane-oxygenation-circuit
#2
Ayse Filiz Yetimakman, Murat Tanyildiz, Selman Kesici, Esra Kockuzu, Benan Bayrakci
BACKGROUND AND AIMS: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply. MATERIALS AND METHODS: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28682992/connection-of-a-renal-replacement-therapy-or-plasmapheresis-device-to-the-ecmo-circuit
#3
Florent Laverdure, Laurent Masson, Guillaume Tachon, Julien Guihaire, François Stephan
In patients under extracorporeal membrane oxygenation (ECMO) support requiring renal replacement therapy or plasmapheresis, connecting such extracorporeal therapy device to the ECMO circuit provides many advantages compared with central venous catheterization. However, high pressures of the ECMO circuit limit the usefulness of this technique. We propose a new approach to connect extracorporeal therapy lines to the ECMO circuit. Inlet line is connected to the oxygenator, and outlet line is connected either to the femoral artery antegrade perfusion cannula in case of venoarterial ECMO or to the lateral vent of the return cannula in case of venovenous ECMO...
July 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28666474/polyethyleneimine-treated-polyacrylonitrile-membrane-hemofilter-for-critically-ill-patients-receiving-anticoagulant-free-prolonged-intermittent-renal-replacement-therapy-a-single-center-prospective-self-controlled-pilot-study
#4
Tao Su, Qizhuang Jin, Zhongyuan Liu
BACKGROUND: Critically ill patients requiring renal replacement therapy (RRT) are at risk of disease-related bleeding. Systemic heparinization should be avoided. AN69ST, a polyethyleneimine-treated polyacrylonitrile (AN69) membrane hemofilter, can be primed with heparin, improving its local anticoagulative activity. Prolonged intermittent RRT (PI-RRT) is of shorter duration and cheaper, considered as an alternative to continuous RRT. This study was performed to compare the success rate of anticoagulant-free PI-RRT using AN69ST versus AN69 membrane hemofilter...
June 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28535517/coupled-plasma-filtration-adsorption-application-for-liver-and-thyroid-toxins
#5
Gabriele Donati, Irene Capelli, Anna Laura Croci Chiocchini, Nicolò Natali, Anna Scrivo, Gaetano La Manna
Coupled plasma filtration and adsorption (CPFA) is a detoxification system that combines a plasma adsorption circuit and a continuous renal replacement therapy circuit. Its main application is for sepsis and septic shock with or without acute renal failure. Several recent studies have suggested that CPFA can reduce the mortality when the volume of plasma absorbed on the styrenic resin is at least >0.18 L/kg/day. At present, new applications for CPFA are under investigation, also in patients without significant kidney failure...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28341867/a-safe-procedure-for-connecting-a-continuous-renal-replacement-therapy-device-into-an-extracorporeal-membrane-oxygenation-circuit
#6
Natsumi Suga, Yosuke Matsumura, Ryuzo Abe, Noriyuki Hattori, Taka-Aki Nakada, Shigeto Oda
Patients receiving extracorporeal membrane oxygenation (ECMO) often require continuous renal replacement therapy (CRRT). The intra-circuit pressure of adult ECMO usually deviates from the physiological range. We investigated the use of CRRT connected to an ECMO circuit with physiological intra-circuit pressures (0-150 mmHg, defined as the "safety range") using an in vitro experiment involving a water-filled ECMO circuit. The intra-circuit pressure pre-pump, post-pump, and post-oxygenator were measured while varying the height of the pump or ECMO flow...
June 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28328586/percutaneous-isolated-hepatic-perfusion-hemodynamic-monitoring-and-goal-directed-anesthetic-management-a-case-report
#7
Oscar Martin-Delgado, Miguel Rodriguez, Andres Lopez, Miguel A Reina, Emilio De Vicente, Yolanda Quijano, Antonio Echenagusia, Juan A Martinez
The percutaneous isolated hepatic perfusion utilizes a venovenous bypass to administer high-dose chemotherapy exclusively in the liver, getting depurated through a hemofilter before returning to the systemic circulation. The hepatic perfusion is managed under general anesthesia and invasive monitoring as a result of very abrupt changes in venous return and vascular resistances because of the isolation of the hepatic territory and absorption of circulating catecholamines by the hemofilter. We report a case in which we describe the technique, physiologic implications, anesthetic, and goal-directed hemodynamic management for this procedure...
June 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28237981/ex-vivo-ceftolozane-tazobactam-clearance-during-continuous-renal-replacement-therapy
#8
Weerachai Chaijamorn, Alexander R Shaw, Susan J Lewis, Bruce A Mueller
BACKGROUND/AIMS: To determine ceftolozane/tazobactam transmembrane clearances (CLTM) in continuous hemofiltration (CHF) and continuous hemodialysis (CHD) and to determine optimal ceftolozane/tazobactam dosing regimens for patients receiving continuous renal replacement therapy (CRRT). METHOD: Validated, ex vivo CHF and CHD bovine blood models using polysulfone (HF1400) and AN69 (Multiflow 150-M) hemofilters were used to evaluate adsorption and CLTM at different effluent flow rates...
2017: Blood Purification
https://www.readbyqxmd.com/read/28211786/sieving-and-extraction-of-peptides-and-proteins-during-hemofiltration-a-systematic-review%C3%A2
#9
J Scott Baird
The relationship between the sieving coefficient (SC) or extraction ratio (ER) and the molecular weight (MW) of peptide and protein solutes during hemofiltration has not been investigated; it is possible that the SC and ER correlate with MW, permitting an estimate of peptide and protein clearance by hemofiltration in the absence of empiric data. A search for studies of the SC and/or ER for peptide and protein solutes during hemofiltration identified data for β2-microglobulin, brain natriuretic peptide, carperitide, IL-1β, IL-1RA, IL-6, IL-8, lysozyme, myoglobin, neutrophil gelatinase-associated lipocalin, procalcitonin, retinol-binding protein, TNF-α, soluble TNFR-1, soluble TNFR-II, and vasopressin using polyacrylonitrile, polysulfone, polyamide, and cellulose hemofilters...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28164555/continuous-hemodiafiltration-with-an-an69st-hemofilter-an69st-chdf-as-fgf-23-lowering-therapy
#10
Masafumi Yamato, Yusuke Minematsu, Yuta Ikemiya, Junichi Shibata, Junya Fujii, Takumi Minato, Sachie Miyagawa, Kaori Takaori, Yoko Tomiyama, Ikue Nagayama, Akira Wada, Takahito Ito, Hirotsugu Iwatani
BACKGROUND: Recent studies have shown that fibroblast growth factor-23 (FGF-23) is elevated not only in chronic kidney disease (CKD), but also in acute illnesses such as acute kidney injury, septic shock, and acute heart failure. FGF-23 would be not only a simple biomarker but also a direct toxic factor in acute illness. Therefore, lowering circulating FGF-23 levels in clinical practice would be an exciting and valuable interventional strategy. Continuous hemodiafiltration (CHDF) is often performed for the treatment of the aforementioned acute illnesses...
December 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/27896442/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#11
Mayerly Prada Rico, Jaime Fernández Sarmiento, Ana María Rojas Velasquez, Luz Stella González Chaparro, Ricardo Gastelbondo Amaya, Hernando Mulett Hoyos, Daniel Tibaduiza, Ana Maria Quintero Gómez
BACKGROUND: Anticoagulation of the continuous renal replacement therapy (CRRT) circuit is an important technical aspect of this medical procedure. Most studies evaluating the efficacy and safety of citrate use have been carried out in adults, and little evidence is available for the pediatric patient population. The aim of this study was to compare regional citrate anticoagulation versus systemic heparin anticoagulation in terms of the lifetime of hemofilters in a pediatric population receiving CRRT at a pediatric center in Bogota, Colombia...
November 28, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27862103/pharmacokinetics-of-imipenem-cilastatin-burn-intensive-care-unit-patients-undergoing-high-dose-continuous-venovenous-hemofiltration
#12
Bradley A Boucher, Joanna Q Hudson, David M Hill, Joseph M Swanson, G Christopher Wood, S Casey Laizure, Angela Arnold-Ross, Zhe-Yi Hu, William L Hickerson
STUDY OBJECTIVE: High-dose continuous venovenous hemofiltration (CVVH) is a continuous renal replacement therapy (CRRT) used frequently in patients with burns. However, antibiotic dosing is based on inference from studies assessing substantially different methods of CRRT. To address this knowledge gap for imipenem/cilastatin (I/C), we evaluated the systemic and extracorporeal clearances (CLs) of I/C in patients with burns undergoing high-dose CVVH. DESIGN: Prospective clinical pharmacokinetic study...
December 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27861424/experimental-and-clinical-evaluation-of-predilution-and-postdilution-continuous-venovenous-hemofiltration-on-clearance-characteristics
#13
Shinya Chihara, Yoshiki Masuda, Michiaki Yamakage
We compared the clearance characteristics of low-to-high molecular weight substances during pre-and postdilution continuous venovenous hemofiltration (CVVH) in experimental and clinical conditions. Experimental circuits for pre- and postdilution CVVH were prepared using a test solution containing creatinine (110 Da), inulin (5,000 Da), interleukin (IL)-8 (8,000 Da), IL-6 (22,000 Da), and tumor necrosis factor (TNF)-α (51,000 Da). Quantity of test solution flow and filtration flow (QF) were set to 150 ml/min and 10, 20, and 35 ml/min, respectively...
March 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27858178/proteome-analysis-of-hemofilter-adsorbates-to-identify-novel-substances-of-sepsis-a-pilot-study
#14
Tomoaki Hashida, Taka-Aki Nakada, Mamoru Satoh, Keisuke Tomita, Rui Kawaguchi, Fumio Nomura, Shigeto Oda
Blood purification therapy using hemofilters with high adsorbing capabilities has been reported to remove excessive humoral mediators from the blood of patients with sepsis. However, there are insufficient studies of the adsorbates bound to hemofilter membranes. We hypothesized that these adsorbates in acute kidney injury (AKI) patients with sepsis were different from those in patients without sepsis and that proteome analysis of the adsorbates would identify novel substances of sepsis. This study included 20 patients who had AKI upon admission to intensive care units (ICUs) and who received continuous renal replacement therapy using polymethyl methacrylate hemofilters...
June 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27447715/endothelial-bioreactor-system-ameliorates-multiple-organ-dysfunction-in-septic-rats
#15
Shuai Ma, Yuli Lin, Bo Deng, Yin Zheng, Chuanming Hao, Rui He, Feng Ding
BACKGROUND: The endothelium is a potentially valuable target for sepsis therapy. We have previously studied an extracorporeal endothelial cell therapy system, called the endothelial bioreactor (EBR), which prolonged the survival time of endotoxemia sepsis in swine. To further study of the therapeutic effects and possible mechanisms, we established a miniature EBR system for septic rats induced by cecal ligation and puncture (CLP). METHODS: In the miniature EBR system, the extracorporeal circulation first passed through a mini-hemofilter, and the ultrafiltrate (UF) was separated, then the UF passed through an EBR (a 1-mL cartridge containing approximately 2 × 10(6) endothelial cells grown on microcarriers) and interact with endothelial cells...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27391086/kinetics-of-linezolid-in-continuous-renal-replacement-therapy-an-in-vitro-study
#16
Marco Sartori, Arianna Loregian, Silvana Pagni, Silvia De Rosa, Fiorenza Ferrari, Leopolda Zampieri, Mirella Zancato, Giorgio Palú, Claudio Ronco
BACKGROUND: Continuous veno-venous hemofiltration (CVVH) could affect the pharmacokinetic profile of linezolid (LZD). The aim of this study was to evaluate the LZD extracorporeal clearance using an in vitro CVVH model. METHODS: A sham miniaturized CVVH circuit (CARPEDIEM; Bellco, Mirandola, Italy) was set up with a polysulfone hemofilter (0.25 m; cutoff 50,000 Da) for 240 minutes using normal saline solution (0.9% wt/vol NaCl) and blood (n = 6) spiked with LZD. Drug solution samples were collected during CVVH at 10, 30, 60, 120, and 240 minutes...
October 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27102694/the-effect-of-continuous-elimination-methods-on-the-hemostatic-profile-of-a-cardiac-surgery-patient-monitored-using-thromboelastography
#17
Ondřej Zuščich, Roman Hájek, Pavel Ševčík, Vladimír Lonský, Jana Zapletalová
INTRODUCTION: This work is focused on mapping issues of hemostasis in patients during continuous renal replacement therapy, or the possible impact of the use of anticoagulants. METHODS: The study included 30 consecutive patients requiring continuous renal replacement therapy following cardiac surgery in the period of 2009 to 2012. Patients were placed into 2 branches according to the selected method of anticoagulation (regional citrate anticoagulation-RCA, unfractionated heparin UFH)...
May 16, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/26978710/first-implantation-of-silicon-nanopore-membrane-hemofilters
#18
Clark Kensinger, Seth Karp, Rishi Kant, Benjamin W Chui, Kenneth Goldman, Torin Yeager, Edward R Gould, Amanda Buck, David C Laneve, Joseph J Groszek, Shuvo Roy, William H Fissell
An implantable hemofilter for the treatment of kidney failure depends critically on the transport characteristics of the membrane and the biocompatibility of the membrane, cartridge, and blood conduits. A novel membrane with slit-shaped pores optimizes the trade-off between permeability and selectivity, enabling implanted therapy. Sustained (3-8) day function of an implanted parallel-plate hemofilter with minimal anticoagulation was achieved by considering biocompatibility at the subnanometer scale of chemical interactions and the millimeter scale of blood fluid dynamics...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/26955702/-effect-of-hemofiltration-combined-with-hemoabsorption-on-improvement-of-immune-function-in-septic-patients-with-low-expression-of-human-leukocyte-antigen-dr
#19
RANDOMIZED CONTROLLED TRIAL
Ying Lijun, Lyu Tie, Yan Jing
OBJECTIVE: To investigate the effect on improving immune function by hemofiltration combined with hemoabsorption in septic patients with low human leukocyte antigen DR (HLA-DR) expression. METHODS: A prospective randomized controlled trial was conducted. Sixty sepsis patients aged over 18 years, with HLA-DR expression lower than 30% were enrolled, and they were randomly divided into experimental group and control group, n = 30 in each group. The patients were treated with standard operating procedure for sepsis, and hemofiltration combined with hemoabsorption were added in addition in the experimental group within 1-3 days...
September 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/26711775/doripenem-treatment-during-continuous-renal-replacement-therapy
#20
M G Vossen, J M Wenisch, A Maier-Salamon, A Fritsch, K Saria, C Zuba, S Jilch, R Lemmerer, M Unger, U Jaehde, W Jäger, F Thalhammer
Doripenem is a broad-spectrum parenteral carbapenem with enhanced activity against Pseudomonas aeruginosa. While the initial dosing recommendation for renally competent patients and patients undergoing continuous renal replacement therapy (cRRT) was 500 mg every 8 h (q8h), the dose for renally competent patients was updated to 1 g q8h in June 2012. There are no updated data for the dosing of patients on continuous renal replacement therapy. The original dosing regimen for cRRT patients was based on nonseptic patients, while newer publications chose comparatively low target concentrations for a carbapenem...
December 28, 2015: Antimicrobial Agents and Chemotherapy
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