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普利斯玛 Flex™HF20 套装和普利斯玛 Flex™系统 7.10 在儿童急性连续肾脏替代治疗(CKRT)中的临床评估。

Clinical evaluation of the Prismaflex™ HF 20 set and Prismaflex™ system 7.10 for acute continuous kidney replacement therapy (CKRT) in children.

机构信息

Seattle Children's, Seattle, WA, USA.

University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA.

出版信息

Pediatr Nephrol. 2020 Dec;35(12):2345-2352. doi: 10.1007/s00467-020-04664-7. Epub 2020 Jun 30.

DOI:10.1007/s00467-020-04664-7
PMID:32607769
Abstract

BACKGROUND

Continuous kidney replacement therapy (CKRT) is a common modality for treatment of severe acute kidney injury (AKI) in children. Adult technologies routinely utilized to provide this therapy have a large extracorporeal volume. The Prismaflex™ HF20 filter set has a relatively low extracorporeal blood volume of 60 mL, which provides technological benefit for smaller children compared with current filter sets available in the USA.

METHODS

We conducted a multicenter, open-label single group study to evaluate whether the Prismaflex™ HF20 filter set delivers efficacious and safe CKRT to support patients with AKI, fluid overload, or both in pediatric patients weighing ≥ 8 to 20 kg.

RESULTS

Twenty-three patients were enrolled between April 24, 2016 and April 8, 2018. The mean reduction in blood urea nitrogen from baseline to 24 h was 58.12 ± 20.08% (95% CI, - 68.45 and - 47.79 (p = 0.0008)). Median cumulative normalized effluent rate at 24 h was 60.8 mL/kg/h (25.9, 83.7). None of the patients participating in the study suffered a serious adverse event; thus, no obvious safety concerns were noted.

CONCLUSIONS

We suggest that the Prismaflex HF20™ filter set used in conjunction with the Prismaflex™ System Software Version 7.10 or 7.20 is a suitable alternative to larger filter sets for use in pediatric patients weighing less than 20 kg. Graphical abstract.

摘要

背景

连续肾脏替代疗法(CKRT)是治疗儿童严重急性肾损伤(AKI)的常用方法。用于提供这种治疗的成人技术常规具有较大的体外体积。Prismaflex™ HF20 过滤器组具有相对较低的 60 毫升体外血液量,与目前在美国可用的过滤器组相比,为较小的儿童提供了技术优势。

方法

我们进行了一项多中心、开放标签的单组研究,以评估 Prismaflex™ HF20 过滤器组是否能有效且安全地提供 CKRT,以支持体重≥8 至 20 公斤的 AKI、液体超负荷或两者兼有的儿科患者。

结果

2016 年 4 月 24 日至 2018 年 4 月 8 日期间,共有 23 名患者入组。与基线相比,24 小时时血尿素氮的平均降低率为 58.12±20.08%(95%可信区间,-68.45 至-47.79(p=0.0008))。24 小时时累积标准化洗脱率中位数为 60.8 毫升/公斤/小时(25.9,83.7)。参与研究的患者均未发生严重不良事件;因此,未发现明显的安全问题。

结论

我们建议,与 Prismaflex™ 系统软件版本 7.10 或 7.20 一起使用的 Prismaflex HF20™ 过滤器组是小于 20 公斤的儿科患者使用较大过滤器组的合适替代方案。

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