A new semiempirical mathematical model for prediction of internal filtration in hollow fiber hemodialyzers
A new semiempirical mathematical model for prediction of internal filtration in hollow fiber hemodialyzers
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DOI：
10.1159/000097079
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发表时间：
2006-01-01
影响因子：
3
通讯作者：
Ronco, Claudio
中科院分区：
文献类型：
--
作者：
Fiore, Gianfranco B.;Guadagni, Gualtiero;Ronco, Claudio
对流溶质输运用于血液净化的潜力已被广泛探索。以扩散和对流技术相结合为基础的新技术(如血液透析过滤)已经开发出来。由于内滤/反滤(IF/BF)现象，高通量透析也依赖于对流成分，然而，对流成分很难量化并因此优化。在这项工作中，我们开发了一个数学模型，旨在为临床医生提供高通量透析过程中IF/BF通量的量化。根据机器设置和血细胞比容/蛋白质浓度预测流量。商业透析器的水力特性是通过无血台架试验得出的。此外，在1.8m(2)聚砜透析器上进行了体外血液测试，使用建立的闪烁照相分析来验证模型预测的准确性。模拟结果表明，IF/BF比率对血液流速敏感，对透析液流速的敏感性较小。增加净超滤速度会导致直接过滤的平行增加和BF的同时减少。IF/BF受血液成分的影响较大，因为红细胞压积和血浆蛋白浓度对红细胞压积和血液粘度有复杂的依赖关系。模拟结果与实验结果吻合较好，只有3%的预测误差。与前人的一些工作相比，该模型在理论方法上更为简单。它允许应用到用户友好的软件工具中，并可用于预测高通量透析中的对流成分，并可能对其进行优化。版权所有(C)2006 S.Karger AG，巴塞尔。
The potential of convective solute transport for blood purification has been widely explored. New techniques (such as hemodiafiltration), based on a combination of diffusion and convection techniques, have been developed. Owing to the internal filtration/backfiltration (IF/BF) phenomenon, high-flux dialysis also relies on a convective component, which, however, is hard to quantify and thus optimize. In this work, we developed a mathematical model designed to supply the clinician with a quantification of the IF/BF fluxes taking place during high-flux dialysis. IF fluxes are predicted based on the machine settings and blood hematocrit/protein concentration. The hydraulic characteristics of commercial dialyzers were derived from bloodless bench tests. Moreover, an in vitro blood test was conducted on a 1.8 m(2) polysulfone dialyzer using an established scintigraphic analysis, for verification of model prediction accuracy. Results of simulations show that the IF/BF rate is sensitive to the blood flow rate and (to a lesser extent) to the dialysate flow rate. Increasing net ultrafiltration rates resulted in parallel increases of direct filtration and simultaneous decreases of BF. IF/BF is rather influenced by blood composition, due to the complex dependence of oncotic pressure and blood viscosity upon hematocrit and plasma protein concentration. Simulation results showed an excellent agreement with the experimental results obtained with scintigraphy, with only a 3% prediction error. With respect to some previous works, this model is simpler in its theoretical approach. It allows implementation into a user-friendly software tool and might be used to predict the convective component in high-flux dialysis and possibly to optimize it. Copyright (c) 2006 S. Karger AG, Basel.