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Extracorporeal dialysis: techniques and adequacy - A

4Citations signalées, ce qui n’est pas une note de qualité
21Institutions déclarées
10Pays d’affiliation déclarés

Rattachement africain : it, at, pl, jp, gr, de, sg, se, il, fr. Niveau de preuve : code pays fourni par la source.

Le résumé fourni par la source

Introduction and Aims: The biofeedback on TMP, as UltraControl (UC, Gambro), enhances and automatically adjusts the convective volume in hemodiafiltration online (OL-HDF).Moreover, the results of recent RCTs on postdilution OL HDF, such as CONTRAST and TURKISH, suggest that OL-HDF with high convective volume can improve the patient survival.This study evaluated the convective performances of UC in post-dilution OL-HDF on two dialysis machines: AK200 ULTRA S (AK) and ARTIS.Methods: We enrolled 14 stable pts (63±12 yrs), already treated by OL-HDF, in a sequential design study of two weeks for each monitor.Both monitors automatically set the infusion volume by a biofeedback on TMP (described by Teatini et al.Blood Purif 2011), while AK measures the TMP value by 3 points formula (Pre-filter, venous and inlet dialysate pressure) and uses a TMP step of 25mmHg, ARTIS works with 4 points (Pre-filter, venous, inlet and outlet dialysate pressure) and TMP step of 20mmHg.For each patient the remaining technical parameters were kept unchanged.The infusion volume, TMP and Pre-filter pressure (PFP) were hourly collected.All the pts were treated with 2.1 m2 Polyflux H (Gambro).The descriptive analysis was based on the mean ± standard deviation.Inferential statistics included two tailed t-test for paired data, considering a probability value of less than 0.05 as significant.Results: No differences were found on main dialytic parameters, such as Qb (371±10 vs 370±12 ml/min, p=0.978), treatment time (265±16 vs 266±16 min, p=0.334) and total weight loss (1.8±0.7 vs 1.8±0.7 L, p=0.739), between the two periods.The ARTIS system reached a smooth higher infusion volume (27.0±2.5Lvs 25.8±2.3L,p<0.01) with a different pressure trend (see figure 1).The intra-patient coefficient of variability on infusion volume was lower with ARTIS machine than AK machine (7.8±3.4 vs 6.4 ±3.4%).Conclusions: UltraControl reached high convective volumes (>20 L) in postdilution OL HDF with AK and ARTIS machine.The introduction of 4 points TMP measuring and a smaller increment TMP step resulted in more optimize TMP setpoint, leading to an increase of infusion volume and reduction of the intra-patient variability on ARTIS machine.Therefore UltraControl system on ARTIS seems to be the best technique for Postdilution OL-HDF.

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Le contrôle bibliographique ouvert

DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref
Extracorporeal dialysis: techniques and adequacy - A
Date Crossref
01/05/2013
Éditeur
Oxford University Press (OUP)
Type
journal-article

Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.

Les institutions déclarées

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Les sujets associés

Dialysis and Renal Disease ManagementMechanical Circulatory Support DevicesRenal Transplantation Outcomes and Treatments

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