Department of Medicine, Nephrology, Dialysis and Transplant Unit, University of Padua, Padova, Italy.
Azienda Zero, Padova, Italy.
Artif Organs. 2022 Aug;46(8):1695-1700. doi: 10.1111/aor.14253. Epub 2022 Apr 20.
Slow continuous ultrafiltration (SCUF) by central venous catheter (CVC) for hemodialysis is a simple extracorporeal ultrafiltration that can reduce and control fluid overload in patients with chronic or acute chronic heart failure unresponsive to medical therapy. In order to avoid complications and risks related to the catheterization with a standard CVC for hemodialysis to provide the SCUF, considering that hospitalized patients affected by congestive heart failure commonly undergo CVC placement for medications delivering, we tested an in vitro model to use a standard CVC for infusion to perform SCUF.
We performed an in vitro SCUF experimental model through two different lumens of a triple (8Fr × 20 cm Tri-lumen catheter Kit-Envans Extra) and a quad-lumen CVC (8.5Fr × 20 cm Quad-lumen catheter kit-Benefis Medical Devices) commonly used in our Intensive Care Unit for fluids and medications infusions. We used Prismaflex with the HF-20 set (Baxter, IL, USA) to perform the SCUF treatment.
Our in vitro data confirm the technical feasibility of the use of standard CVC for fluid infusion to perform a SCUF treatment with a theoretical weight loss of up to 200 ml/h by a blood flow ranging from 30 to 45 ml/min.
The use of standard infusion CVC could be utilized in the intensive care unit to perform SCUF not exposing patients to the risks and complications related to the placement and permanence of CVC for hemodialysis.
通过中心静脉导管(CVC)进行缓慢持续超滤(SCUF)是一种简单的体外超滤,可以减少和控制对药物治疗无反应的慢性或急性慢性心力衰竭患者的液体超负荷。为了避免与用于提供 SCUF 的标准 CVC 进行血液透析相关的导管相关并发症和风险,考虑到因充血性心力衰竭而住院的患者通常需要进行 CVC 置管以输送药物,我们测试了一种使用标准 CVC 进行输液的体外模型来进行 SCUF。
我们通过三重(8Fr×20cmTri-lumen 导管套件-EnvansExtra)和四腔 CVC(8.5Fr×20cmQuad-lumen 导管套件-BenefisMedicalDevices)的两个不同腔进行体外 SCUF 实验模型,这些 CVC 通常在我们的重症监护病房中用于输液和药物输注。我们使用 Prismaflex 与 HF-20 套件(Baxter,IL,美国)进行 SCUF 治疗。
我们的体外数据证实了使用标准 CVC 进行输液以进行 SCUF 治疗的技术可行性,通过血流范围为 30 至 45ml/min,可以实现高达 200ml/h 的理论体重减轻。
标准输注 CVC 可在重症监护病房中用于进行 SCUF,而不会使患者面临与用于血液透析的 CVC 放置和留置相关的风险和并发症。