Ronco C, Brendolan A, Everard P, Irone M, Ballestri M, Cappelli G, Inguaggiato P, Bellomo R
Dept of Nephrology, St. Bortolo Hospital, Vicenza, Italy.
J Nephrol. 1999 Jul-Aug;12(4):241-7.
The evolution of technology and biomaterials has permitted a parallel development of renal replacement therapies in the acute, critically ill patient. From the original continuous artero-venous hemofiltration method new techniques such as continuous veno-venous hemofiltration, hemodiafiltration and high-flux dialysis have been developed and are clinically used. Similar progress has been made with artificial membranes. We investigated the possibility of using a modified cellulosic membrane for continuous therapies, assessing the hydraulic characteristics and clearance performances of high-flux cellulose triacetate hemodiafilter (0.7 m2) in vitro and in vivo. The flowdynamic characteristics of the filter suggest its optimal use in veno-venous pump-drive techniques. Efficiency was excellent, with urea daily clearances as high as 50 liters or more. The high permeability and porosity of the membrane also increased the clearances of larger solutes such as creatinine and inulin. No side effects occurred during treatment and we conclude that cellulose triacetate may be considered a good alternative to synthetic membranes in continuous renal replacement therapies.
技术和生物材料的发展使得针对急性危重症患者的肾脏替代疗法得以同步发展。从最初的持续动静脉血液滤过方法，已开发出如持续静静脉血液滤过、血液透析滤过和高通量透析等新技术并应用于临床。人工膜方面也取得了类似进展。我们研究了使用改良纤维素膜进行持续治疗的可能性，在体外和体内评估了高通量三醋酸纤维素血液透析滤过器（0.7平方米）的水力特性和清除性能。该滤过器的流体动力学特性表明其在静静脉泵驱动技术中具有最佳应用效果。效率极佳，尿素日清除率高达50升或更高。膜的高渗透性和孔隙率也增加了肌酐和菊粉等较大溶质的清除率。治疗过程中未出现副作用，我们得出结论，在持续肾脏替代疗法中，三醋酸纤维素可被视为合成膜的良好替代品。
