Yoshizawa Mitsutaka, Nakatsuji Yoshiyuki
Department of Clinical Engineering, Marunouchi Hospital, Matsumoto, Japan.
Department of Gastroenterology, Marunouchi Hospital, Matsumoto, Japan.
Ther Apher Dial. 2019 Jun;23(3):233-236. doi: 10.1111/1744-9987.12829.
There are major problems with the occlusion of filtration membrane and fever of patients in the cell-free and concentrated ascites reinfusion therapy (CART) system using internal pressure-type filtration. We constructed a modified CART system using external pressure-type filtration in order to resolve the major problems. After we adopted the external pressure-type filtration for CART system with the safety level raised, we studied the volume of treated ascites, the weight of recovered protein, and the body temperature of patients after the reinfusing of concentrated ascites in five cases with refractory ascites. There were no cancelled trials despite membrane occlusion in two of 22 trials. Moreover, use of this modified CART system could minimize the temperature increase of patients and suppress the occurrence of that variation with steroid injection. We were able to construct the modified CART system using external pressure-type filtration. This improved and safe CART system could be widely used by any facilities.
在使用内压式过滤的无细胞浓缩腹水回输疗法（CART）系统中，存在滤过膜堵塞和患者发热的重大问题。为了解决这些主要问题，我们构建了一种采用外压式过滤的改良CART系统。在提高安全水平的CART系统采用外压式过滤后，我们研究了5例难治性腹水患者在回输浓缩腹水后的治疗腹水量、回收蛋白重量和患者体温。在22次试验中有2次尽管出现膜堵塞，但没有试验被取消。此外，使用这种改良的CART系统可以使患者体温升高最小化，并抑制注射类固醇引起的体温变化。我们能够构建采用外压式过滤的改良CART系统。这种改良且安全的CART系统可被任何医疗机构广泛使用。
