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体内评估手动单腔交替微批量血液透析滤过系统。

In vivo Assessment of a Manual Single Lumen Alternating Micro-Batch Hemodiafiltration System.

机构信息

Innovative BioTherapies Inc, Ann Arbor, Michigan, USA.

Innovative BioTherapies Inc, Ann Arbor, Michigan, USA,

出版信息

Blood Purif. 2024;53(8):650-656. doi: 10.1159/000538358. Epub 2024 Mar 27.

Abstract

INTRODUCTION

The manual single lumen alternating micro-batch hemodiafiltration (mSLAMB) system is a closed-loop dialysis system designed to provide kidney support in emergency situations (e.g., fluid overload, hyperkalemia, acidemia). If done repeatedly in small batches and at high flow rates, this system was found to achieve clearance levels comparable to traditional renal replacement therapy.

METHODS

Using a porcine model, uremic toxins and exogenous fluorescent tracer concentrations were successfully lowered within just 1 h of treatment.

RESULTS

With a maximal dialysate flow, mSLAMB can achieve decreases in serum potassium concentration of >0.5 mmol/L/h. With the mSLAMB hemodiafiltration system, micro-batch processing was also successful in removing up to 250 mL of ultrafiltrate in 8 cycles.

CONCLUSION

This process could create a better fluid balance allowing for administering therapeutic fluids such as sodium bicarbonate in the clinic. Electrolyte imbalance and volume overload remain severe life-threatening emergencies in low resource settings; therefore, mSLAMB should be explored further due to its modest vascular access requirements, low cost, and ability to be performed without electricity or batteries.

摘要

简介

手动单腔交替微批量血液透析滤过(mSLAMB)系统是一种闭环透析系统,旨在为紧急情况下(例如,液体超负荷、高钾血症、酸中毒)提供肾脏支持。如果以小批量和高流速重复进行,该系统发现可达到与传统肾脏替代治疗相当的清除水平。

方法

在猪模型中,在治疗开始后仅 1 小时内成功降低了尿毒症毒素和外源性荧光示踪剂的浓度。

结果

在最大透析液流速下,mSLAMB 可使血清钾浓度降低 >0.5mmol/L/h。使用 mSLAMB 血液透析滤过系统,微批量处理还成功地在 8 个循环中去除了多达 250mL 的超滤液。

结论

这个过程可以创造更好的液体平衡,从而可以在诊所中给予碳酸氢钠等治疗性液体。在资源匮乏的环境中,电解质失衡和容量超负荷仍然是严重的危及生命的紧急情况;因此,由于 mSLAMB 血管通路要求低、成本低且无需电力或电池即可进行,因此应该进一步探索。

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