Prospects for using a hemoconcentrator as an alternative hemodialysis method in cardiopulmonary bypass surgeries

Tagaya, Masashi; Matsuda, Morihiro; Yakehiro, Masuhide; Izutani, Hironori

doi:10.1177/0267659113502831

Cited by 8 publications

(7 citation statements)

References 23 publications

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“…20 Furthermore, a hemofilter is used for various perfusion techniques such as modified ultrafiltration, 21 dilutional ultrafiltration, 22 zero-balance ultrafiltration, 23 or any other hemopurification method. 24,25 These techniques also require blood circulation into a hemofilter for prolonged duration. Considering that the BPCA-coated hemofilter reduces antithrombin consumption, it could produce beneficial effects during the post-extracorporeal circulation phase.…”

Section: Discussionmentioning

confidence: 99%

Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

et al. 2018

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Objective:Extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPCA) that has a hydrophilic blood-contacting layer, but hemofilters are not. We aimed to investigate the antithrombotic properties of a BPCA-coated hemofilter.Methods:Four experiments using BPCA-coated circuits and non-coated hemofilters and four experiments using BPCA-coated circuits and BPCA-coated hemofilters were performed with whole human blood and compared by measuring the circuit pressure every 5 min, antithrombin activity every 40 min, and thrombin–antithrombin complex every 40 min, for a total of 240 min of recirculation.Results:The mean time required for the pressure at the inlet of the hemofilter to increase sharply was longer in BPCA-coated than in non-coated hemofilters (66 ± 11 min vs 25 ± 9 min, p < 0.01). The mean antithrombin activity value at 200 and 240 min of recirculation was significantly higher in the experiments with BPCA-coated versus non-coated hemofilters (43.3 ± 2.87 vs 33.3 ± 5.74, p = 0.04; 42.8 ± 3.59 vs 31.0 ± 5.35, p = 0.01, respectively); the antithrombin activity values at the other time points were not significantly different. Furthermore, all thrombin–antithrombin complex values in experiments with the BPCA-coated hemofilters achieved overrange at 80 min of recirculation, whereas those with the non-coated hemofilter achieved overrange at 40 min.Conclusion:This study suggests that BPCA-coated hemofilters can inhibit antithrombin consumption, contributing to antithrombotic effects in extracorporeal circulation circuits.

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Section: Discussionmentioning

confidence: 99%

Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

et al. 2018

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“…A total of 5 L of bovine blood, calibrated to an Hct of 24%, a K + level of 7.5 mmol/L and a glucose concentration of 210 mg/dL, was maintained at a temperature of 37°C, with continuous stirring. The blood was recirculated through a hemoconcentrator (Aqua Stream, JMS, Tokyo, Japan) at 300 ml/min in a DUF experimental circuit, as reported in our previous study, 7 equipped with roller pumps and sampling ports. After a 5-min recirculation period (to eliminate any errors caused by the saline priming), the blood was sampled to measure the baseline data.…”

Section: Methodsmentioning

confidence: 99%

“…The conventional hemoconcentration circuit was improved by adding a switching junction without requiring any additional equipment, as reported in our previous study. 7 Further, we suggested that HD with a hemoconcentrator instead of a hemodialyzer (or alternative hemodialysis [ALTHD]) is beneficial in clinical practice. However, for ALTHD to be used in clinical practice, its features need to be clarified.…”

Section: Introductionmentioning

confidence: 99%

Features of an alternative hemodialysis method using a hemoconcentrator during cardiopulmonary bypass surgeries

et al. 2014

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“…Hemodialysis serves to compensate for impaired renal function in patients with end-stage renal disease. A hemodialyzer consists of a membrane that corrects the levels of blood components mainly through diffusion ( 1 – 4 ). In order to correct blood component imbalances, patients undergo hemodialysis three times weekly for 3 to 4 hours per session ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Hemodialysis Membrane Coated with a Polymer Having a Hydrophilic Blood-Contacting Layer can Enhance Diffusional Performance

et al. 2017

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PurposeCurrently, the foreign surfaces of various extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPA), which creates a hydrophilic blood-contacting layer to reduce thrombogenicity, while the membranes in hemodialyzers are not. We aimed to clarify other side effects of BPA-coated membranes by examining the diffusion performance in in vitro experiments.MethodsWe used a polyethersulfone membrane (sieving coefficient of albumin is ≤0.01) coated with BPA product, SEC-1™ (Toyobo), in a hemodialyzer. To estimate the diffusion rates of a wide range of molecules, 2 L of saline containing vancomycin, lysozyme, and albumin were recirculated in the circuit configured with a hemodialyzer, and dialyzed continuously using water. The concentrations of sodium, vancomycin, lysozyme, and albumin were measured every 5 minutes for 30 minutes and compared in experiments with BPA-coated (n = 4) and BPA-noncoated (n = 4) membranes.ResultsThe removal rates of sodium and vancomycin after 5 minutes of dialysis (n = 24) were significantly higher in BPA-coated than noncoated membranes, while those of lysozyme and albumin were not significantly different. The removal rates of sodium and vancomycin after 30 minutes of dialysis (n = 4) were significantly higher, and those of lysozyme were significantly lower in BPA-coated than noncoated membranes, while those of albumin were not significantly different.ConclusionsThe preliminary study suggests that BPA-coated membranes enhanced the diffusion rate of molecules with low and middle molecular weight without affecting the sieving coefficient of albumin. Thus, BPA coating can enhance the dialysis performance of membranes.

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Prospects for using a hemoconcentrator as an alternative hemodialysis method in cardiopulmonary bypass surgeries

Cited by 8 publications

References 23 publications

Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

Features of an alternative hemodialysis method using a hemoconcentrator during cardiopulmonary bypass surgeries

Hemodialysis Membrane Coated with a Polymer Having a Hydrophilic Blood-Contacting Layer can Enhance Diffusional Performance

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