创新一种新生儿腹膜透析导管，以扩大资源匮乏环境中危重新生儿的透析能力。
Innovation of a Neonatal Peritoneal Dialysis Catheter to Expand Dialysis Capabilities for Critically Ill Neonates in Low-Resource Settings.
作者信息
Ruiz Vega Sergio, Russell Lll Carl, Zhang Siting, McCulloch Mignon, Lottes Aaron, Lee Hyowon, Soranno Danielle E
机构信息
Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA.
Birck Nanotechnology Center, Purdue University, West Lafayette, Indiana, USA.
出版信息
Blood Purif. 2025;54(3):167-173. doi: 10.1159/000542613. Epub 2025 Jan 2.
INTRODUCTION
The lack of peritoneal dialysis (PD) catheters designed explicitly for neonates creates significant challenges in the provision of neonatal PD. High resource settings can circumvent this limitation by resorting to alternative extracorporeal dialysis methods. However, in low-resource settings, PD remains the preferred dialysis modality, and the use of off-label catheters for PD results in complications such as omental wrapping and occlusion. This study introduces a novel catheter design featuring a multi-diameter side port configuration and a helical geometry.
METHODS
We employed numerical simulations to identify an optimal multi-diameter side port configuration, to address fluid dynamic issues that lead to catheter occlusion and omental wrapping. Following the simulations, we experimentally evaluated the catheter's performance in a series of benchtop tests designed to simulate physiological conditions encountered in neonatal PD.
RESULTS
Our experimental evaluations demonstrated that the helical catheter outperforms commonly utilized pigtail catheters with same-sized diameter side ports by consistently achieving superior drainage efficiency during fibrin clot occlusion and omental wrapping tests.
CONCLUSION
The catheter is intended to be placed at the bedside to perform renal replacement therapy for neonates in low-resourced settings.
INTRODUCTION
The lack of peritoneal dialysis (PD) catheters designed explicitly for neonates creates significant challenges in the provision of neonatal PD. High resource settings can circumvent this limitation by resorting to alternative extracorporeal dialysis methods. However, in low-resource settings, PD remains the preferred dialysis modality, and the use of off-label catheters for PD results in complications such as omental wrapping and occlusion. This study introduces a novel catheter design featuring a multi-diameter side port configuration and a helical geometry.
METHODS
We employed numerical simulations to identify an optimal multi-diameter side port configuration, to address fluid dynamic issues that lead to catheter occlusion and omental wrapping. Following the simulations, we experimentally evaluated the catheter's performance in a series of benchtop tests designed to simulate physiological conditions encountered in neonatal PD.
RESULTS
Our experimental evaluations demonstrated that the helical catheter outperforms commonly utilized pigtail catheters with same-sized diameter side ports by consistently achieving superior drainage efficiency during fibrin clot occlusion and omental wrapping tests.
CONCLUSION
The catheter is intended to be placed at the bedside to perform renal replacement therapy for neonates in low-resourced settings.
引言
缺乏专门为新生儿设计的腹膜透析（PD）导管给新生儿腹膜透析的实施带来了重大挑战。资源丰富的地区可以通过采用替代的体外透析方法来规避这一限制。然而，在资源匮乏的地区，腹膜透析仍然是首选的透析方式，使用非标签导管进行腹膜透析会导致诸如网膜包裹和堵塞等并发症。本研究介绍了一种具有多直径侧孔配置和螺旋几何形状的新型导管设计。
方法
我们采用数值模拟来确定最佳的多直径侧孔配置，以解决导致导管堵塞和网膜包裹的流体动力学问题。模拟之后，我们在一系列旨在模拟新生儿腹膜透析中遇到的生理状况的台式试验中对导管的性能进行了实验评估。
结果
我们的实验评估表明，在纤维蛋白凝块堵塞和网膜包裹试验中，螺旋导管始终能实现更高的引流效率，优于具有相同直径侧孔的常用猪尾导管。
结论
该导管旨在放置在床边，为资源匮乏地区的新生儿进行肾脏替代治疗。
引言
缺乏专门为新生儿设计的腹膜透析（PD）导管给新生儿腹膜透析的实施带来了重大挑战。资源丰富的地区可以通过采用替代的体外透析方法来规避这一限制。然而，在资源匮乏的地区，腹膜透析仍然是首选的透析方式，使用非标签导管进行腹膜透析会导致诸如网膜包裹和堵塞等并发症。本研究介绍了一种具有多直径侧孔配置和螺旋几何形状的新型导管设计。
方法
我们采用数值模拟来确定最佳的多直径侧孔配置，以解决导致导管堵塞和网膜包裹的流体动力学问题。模拟之后，我们在一系列旨在模拟新生儿腹膜透析中遇到的生理状况的台式试验中对导管的性能进行了实验评估。
结果
我们的实验评估表明，在纤维蛋白凝块堵塞和网膜包裹试验中，螺旋导管始终能实现更高的引流效率，优于具有相同直径侧孔的常用猪尾导管。
结论
该导管旨在放置在床边，为资源匮乏地区的新生儿进行肾脏替代治疗。
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