Department of Nephrology Dialysis and Transplant St. Bortolo Hospital, Vicenza, Italy.
International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy.
Cardiorenal Med. 2023;13(1):167-175. doi: 10.1159/000530382. Epub 2023 Mar 28.
We have recently developed a new miniaturized device for extracorporeal ultrafiltration (UF) to be used in patients with fluid overload: Artificial Diuresis-1 (AD1) (Medica S.p.A., Medolla, Italy). The device has a reduced priming volume, operates at very low pressures and flow regimes, and is designed to perform extracorporeal UF at bedside. After accurate experiments were carried out in vitro, we report in this paper the results of in vivo UF sessions carried out in selected animals according to veterinary best practice.
The AD1 kit is pre-filled with sterile isotonic solution and operates with a polysulfone mini-filter, MediSulfone (polysulfone at 50,000 Dalton). A collection bag with a volumetric scale is connected to the UF line, and the ultrafiltrate is obtained by gravity based on the height at which the ultrafiltrate collection bag is placed. Animals were prepared and anesthetized. The jugular vein was cannulated with a double-lumen catheter. Three 6-h sessions of UF were scheduled with a target fluid removal of 1,500 mL. Heparin was used as anticoagulant.
In all treatments, the target value of UF was obtained in the absence of major clinical or technical problems with a maximum deviation from the scheduled UF rate lower than 10%. The device resulted to be safe, reliable, accurate, and easily usable thanks to a user-friendly interface and its very small dimensions.
This study opens the way for clinical trials in different settings including departments with low intensity of care and even in ambulatory centers or patient's home.
我们最近开发了一种用于体外超滤(UF)的新型微型设备,用于治疗液体超负荷患者:人工利尿-1(AD1)(意大利梅多拉的 Medica S.p.A.)。该设备具有较小的预充体积,可在极低的压力和流量下运行,旨在床边进行体外 UF。在进行了准确的体外实验后,我们根据兽医最佳实践,在选定的动物中报告了体内 UF 治疗的结果。
AD1 套件预先填充有无菌等渗溶液,并使用聚砜 mini 过滤器 MediSulfone(50,000 道尔顿的聚砜)运行。UF 线连接有一个带有容积刻度的收集袋,根据收集袋的高度,超滤液通过重力获得。动物经过准备和麻醉。颈静脉通过双腔导管进行插管。计划进行 3 次 6 小时 UF 治疗,目标是去除 1,500 毫升液体。肝素用作抗凝剂。
在所有治疗中,在没有出现重大临床或技术问题的情况下,达到了 UF 的目标值,最大偏差低于预定 UF 率的 10%。该设备由于具有用户友好的界面和非常小的尺寸,安全、可靠、准确且易于使用。
这项研究为在不同环境中进行临床试验开辟了道路,包括护理强度较低的部门,甚至可以在门诊中心或患者家中进行。