Mu Changjun, Yamashita Akihiro C
Department of Chemical Science and Technology, Faculty of Bioscience and Applied Chemistry, Hosei University, Tokyo, Japan.
Shandong Weigao Blood Purification Products Co. Ltd., Weihai, China.
Int J Artif Organs. 2023 Apr;46(4):202-208. doi: 10.1177/03913988231155941. Epub 2023 Mar 12.
Continuous renal replacement therapy (CRRT) has become the most commonly used acute blood purification therapy for critically ill patients. As a key point of extracorporeal blood circulation, the CRRT filter plays a decisive role in therapeutic efficacy. However, few in vitro studies have been conducted on CRRT filters, particularly concerning the effects of design factors on filter effectiveness and safety profile; no comprehensive evaluation system has been established. Here, we designed nine CRRT filters with various combinations of hollow fiber packing density () and housing shape (effective hollow fiber length () and inner housing diameter () ratio (/ ratio)) and introduced a high-frequency sampling pressure monitor to accurately monitor small changes in transmembrane pressure () and ultrafiltration rate () over time. We also used concentration polarization mass transfer resistance (), change in sieving coefficient () of albumin over time, and amount of albumin removed () to investigate the effects of two design factors on albumin filtration performance and analyze the mechanism of protein filtration performance over time, thereby establishing a comprehensive in vitro evaluation system to explore the safety profile of CRRT filters. Our results showed that the nine CRRT filters designed with different combinations of (50%, 55%, and 60%) and / ratio (2.9, 5.3, and 9.3) were able to maintain stability in terms of hemodynamics and water permeability; the lowest was 60% and / ratio = 9.3, which indicates that design factor optimization can effectively control albumin filtration, thereby improving the safety profile of CRRT filters.
连续性肾脏替代治疗（CRRT）已成为危重症患者最常用的急性血液净化治疗方法。作为体外血液循环的关键部分，CRRT滤器对治疗效果起着决定性作用。然而，针对CRRT滤器的体外研究较少，特别是关于设计因素对滤器有效性和安全性的影响；尚未建立全面的评估体系。在此，我们设计了九种CRRT滤器，其具有不同的中空纤维填充密度（）和外壳形状（有效中空纤维长度（）与内壳直径（）之比（/比））组合，并引入了高频采样压力监测器，以准确监测跨膜压（）和超滤率（）随时间的微小变化。我们还使用浓度极化传质阻力（）、白蛋白筛分系数（）随时间的变化以及白蛋白清除量（）来研究两种设计因素对白蛋白过滤性能的影响，并分析蛋白质过滤性能随时间变化的机制，从而建立一个全面的体外评估体系，以探索CRRT滤器的安全性。我们的结果表明，采用（50%、55%和60%）与/比（2.9、5.3和9.3）不同组合设计的九种CRRT滤器在血液动力学和水渗透性方面能够保持稳定；最低的是 60%且/比 = 9.3，这表明设计因素优化可有效控制白蛋白过滤，从而改善CRRT滤器的安全性。
