Kim Inbyung, Fealy Nigel, Baldwin Ian, Bellomo Rinaldo
Department of Intensive Care Medicine, Austin Hospital, Melbourne, Australia.
Int J Artif Organs. 2011 Nov;34(11):1061-6. doi: 10.5301/ijao.5000003.
The choice of vascular access catheter may affect filter life during continuous renal replacement therapy (CRRT); specifically, a new surface-modified catheter has been reported to possibly prevent thrombosis and catheter malfunction.
A sequential, controlled study in a tertiary ICU.
To compare circuit life when CRRT was performed with a Bard®Niagara™ catheter or the surface-modified GamCath™ Dolphin® Protect 1320 catheter.
We studied 50 patients with acute kidney injury requiring CRRT, all delivered with catheters in the femoral position. We obtained information on age, gender, disease severity score (APACHE II and APACHE III), filter life, total heparin dose, hemoglobin concentration, platelet count, INR, and aPTT during CRRT.
We studied 341 circuits in 50 patients; 30 patients (140 circuits) used the Niagara and 20 patients (201 circuits) used the Dolphin catheter. Mean of circuit life in two groups was 14.9 hours and 13.1 hours, respectively (p=0.22). Patients using Niagara catheters had a more prolonged APTT (p<0.01) and lower platelet count (p=0.05), while heparin dose (p=0.22), and other anticoagulant treatment (p=0.73) were not significantly different. On Kaplan-Meier survival analysis, circuit life was not significant different between the two catheters (p=0.15).
The Niagara and Dolphin catheters appear to be broadly equivalent in terms of their impact on circuit life.
在持续肾脏替代治疗（CRRT）期间，血管通路导管的选择可能会影响滤器寿命；具体而言，据报道一种新型表面改性导管可能预防血栓形成和导管故障。
在一家三级重症监护病房进行的一项序贯对照研究。
比较使用巴德®尼亚加拉™导管或表面改性的GamCath™海豚®保护1320导管进行CRRT时的回路寿命。
我们研究了50例需要CRRT的急性肾损伤患者，所有患者均通过股静脉置管。我们获取了患者年龄、性别、疾病严重程度评分（急性生理与慢性健康状况评分系统II和III）、滤器寿命、肝素总剂量、血红蛋白浓度、血小板计数、国际标准化比值（INR）以及CRRT期间活化部分凝血活酶时间（aPTT）等信息。
我们研究了50例患者的341个回路；30例患者（140个回路）使用尼亚加拉导管，20例患者（201个回路）使用海豚导管。两组回路寿命的平均值分别为14.9小时和13.1小时（p = 0.22）。使用尼亚加拉导管的患者活化部分凝血活酶时间更长（p < 0.01），血小板计数更低（p = 0.05），而肝素剂量（p = 0.22）和其他抗凝治疗（p = 未找到具体对应内容，推测为0.73）无显著差异。根据Kaplan-Meier生存分析，两种导管的回路寿命无显著差异（p = 0.15）。
尼亚加拉导管和海豚导管在对回路寿命的影响方面似乎大致相当。
