Accelerated hemodialysis: a new safe and simple method of a high filter-low patient blood flow rate hemodialysis.
Accelerated hemodialysis: a new safe and simple method of a high filter-low patient blood flow rate hemodialysis.
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加速血液透析：一种安全、简便的高滤过低患者血流率血液透析的新方法。
DOI：
10.3109/08860229909045191
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发表时间：
1999
期刊：
影响因子：
3
通讯作者：
E. Mohamad
中科院分区：
文献类型：
--
作者：
E. Mohamad
加速血液透析（AHD）是一种新的安全的血液透析方法，使用加速血液透析血液管路（已注册）进行。这些管线允许血液通过再循环段的部分受控再循环。AHD允许在不增加患者血流量的情况下增加过滤器血流量，因此允许使用更高效的较大过滤器，并在透析回路的大部分部分中提供高血流量，以允许无肝素透析。另一方面，可以在不增加滤器血流量的情况下减少患者血流量，并允许低体重患者和血液动力学不稳定或血管评估效率低下的患者进行安全治疗。对一名13岁，体重30 kg的青春期女孩进行了25次血液透析，接受慢性血液透析计划。这些会议包括：使用儿科滤器以130 mL/min的速率进行5次双针血液透析（DNHD）;使用相同滤器以（65 + 65）mL/min的速率进行5次加速血液透析（AHD），并以（130 + 130）mL/min; 5例（DNHD）使用成人血液透析滤过器速率130 mL/min; 5例（AHD）使用相同的滤器，速率为（130 + 130）mL/min。在所有治疗过程中，测量透析前后的BUN和肌酐水平，并计算透析后/透析前比值。在AHD中，测量患者、动脉管路的滤器段和再循环段中的BUN和肌酐水平，并计算实际患者血流量。在儿童和成人滤器中，AHD的效率通过降低实际患者血流量而降低（p < 0.05），但不会通过增加滤器血流量而增加（p > 0.05）。根据BUN和肌酐水平计算，预期患者血流量与实际患者血流量之间无显著变化。AHD是一种简单、安全、适用的血液透析模式，需要进一步研究以验证影响其效率的因素并批准其临床应用。
Accelerated hemodialysis (AHD) is a new safe method of hemodialysis that is done using accelerated hemodialysis blood lines (registered). These lines allow partial controlled recirculation of blood through a recirculation segment. AHD allows increase in the filter blood flow without increasing the patient blood flow and thus allows the use of larger filters of higher efficiency, and provides a high blood flow in most parts of the dialysis circuit to permit heparin free dialysis. On the other hand, the patient blood flow can be decreased without increasing the filter blood flow and allows safe sessions for low body weight patients and those with hemodynamic instability or inefficient vascular assess. Twenty-five hemodialysis sessions were conducted with an adolescent girl, 13 years old, 30 kg body weight, on a chronic hemodialysis program. The sessions included: five double-needle hemodialysis sessions (DNHD) with a pediatric filter at a rate of 130 mL/min; five accelerated hemodialysis sessions (AHD) using the same filter at a rate of (65 + 65) mL/min and another five sessions at rate of (130 + 130) mL/min; five (DNHD) were done using an adult hemodialysis filter rate of 130 mL/min; and five (AHD) using the same filter at a rate of (130 + 130) mL/min. In all sessions pre- and post-dialysis levels of BUN and creatinine were measured and post/predialysis ratios were calculated. In AHD the BUN and creatinine level in the patient, and filter segments of the arterial line and in the recirculation segment were measured and the actual patient blood flow was calculated. The efficiency of AHD was decreased by decreasing the actual patient blood flow (p < 0.05) but was not increased by increasing the filter blood flow in both pediatric and adult filters (p > 0.05). There were no significant changes between the intended patient blood flow rate and the actual patient blood flow as calculated from BUN and creatinine levels. The AHD is a simple safe and applicable mode of hemodialysis that needs further studies to verify factors affecting its efficiency and to approve its clinical applications.