Background: Veno-venous ultrafiltration may benefit patients with acute or chronic circulatory volume overload. Use of conventional systems, however, may be cumbersome, requiring physician placement of a double-lumen central venous catheter and use of a dedicated dialysis technician and apparatus.
Methods: A simplified peripheral ultrafiltration system including a miniaturized disposable circuit was evaluated in patients with volume-overload states. Separate intravenous catheters (16-18 G) for withdrawal and return of blood (blood flow
Results: The primary endpoint of greater than 1 L fluid removal in less than 8 hours was achieved in 23 of 25 treatments. On average, 2611 +/- 1002 mL (maximum 3,725 mL) of ultrafiltrate was removed per treatment (treatment period 6:43 +/- 1:47 hours:minutes). Patient weight decreased from 91.9 +/- 17.5 to 89.3 +/- 17.3 kg (P <.0001) after ultrafiltration. No major adverse events occurred.
Conclusions: Rapid removal of extracellular and intravascular fluid volume excess can be safely achieved via peripherally inserted ultrafiltration without the need for central venous catheter placement.
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http://dx.doi.org/10.1054/jcaf.2003.28 | DOI Listing |
Expert Opin Drug Metab Toxicol
December 2024
UMR 1343, Evaluation des thérapeutiques et pharmacologie périnatale et pédiatrique, INSERM, Université Paris Cité, Paris, France.
Background: Limited data exist on how continuous renal replacement therapy (CRRT) affects antimicrobial dosing in pediatric patients. This study examined the impact of pediatric CRRT parameters on the pharmacokinetics (PK) of meropenem, piperacillin, and tazobactam using an in vitro CRRT model.
Research Design And Methods: An in vitro CRRT model with a pediatric ST60 circuit was used to assess antimicrobial clearance during continuous veno-venous hemodialysis (CVVHD) or hemofiltration (CVVH).
Blood Purif
December 2024
Service de Médecine Intensive - Réanimation, hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.
Blood Purif
October 2024
International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy.
Introduction: Enkephalins, endogenous opioid peptides, are involved in the regulation of renal function. One derived molecule, proenkephalin A, also known as penKid, has been demonstrated to be a reliable biomarker for kidney function and its plasma concentration correlates with measured glomerular filtration rate. penKid is used for prediction and diagnosis of AKI and need of renal replacement therapy (RRT).
View Article and Find Full Text PDFWorld J Crit Care Med
June 2024
Intensive Care Unit, General Hospital of Larissa, Larissa 41221, Greece.
Extracorporeal organ support (ECOS) has made remarkable progress over the last few years. Renal replacement therapy, introduced a few decades ago, was the first available application of ECOS. The subsequent evolution of ECOS enabled the enhanced support to many other organs, including the heart [veno-arterial extracorporeal membrane oxygenation (ECMO), slow continuous ultrafiltration], the lungs (veno-venous ECMO, extracorporeal carbon dioxide removal), and the liver (blood purification techniques for the detoxification of liver toxins).
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