Super high flux hemodialysis at high dialysate flows:: An ex vivo assessment
Super high flux hemodialysis at high dialysate flows:: An ex vivo assessment
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DOI：
10.1177/039139880402700106
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发表时间：
2004-01-01
影响因子：
1.7
通讯作者：
Bellomo, R
中科院分区：
文献类型：
--
作者：
Lee, WCR;Uchino, S;Bellomo, R
背景和目的：标准血液滤过对细胞因子的清除。是有限的。即使在透析模式下使用，超高通量膜也可显著改善去除。我们试图测量细胞因子清除使用一个大的表面超高通量膜和一个标准的血液透析setting. Set：ICU实验室的一个三级机构。coli内毒素刺激细胞因子产生。然后使含有细胞因子的血液以3种不同的透析液流速循环通过透析回路。结果：超高通量透析实现了较高的中位细胞因子清除率（IL-1清除率为106 ml/min，IL-6清除率为66.8 ml/min，IL-8清除率为61.7 ml/min，TNF清除率为36.1 ml/min）。将透析液流速从300 ml/min增加至500 ml/min并未显著增加细胞因子清除率。然而，白蛋白清除率在2.7和5.4 ml/min之间。结论：细胞因子透析是可行的，在高透析液流速产生高细胞因子清除率。然而，白蛋白损失是明显的，在临床环境中可能需要单独补充。
Background and objectives: The removal of cytokines by standard hemofiltration. is limited. Super high flux membranes may significantly improve removal even when used in dialysis mode. We sought to measure cytokine clearance using a large surface super high-flux membrane and a standard hemodialysis setting.Setting: ICU laboratory of a tertiary institution.Subjects: Six healthy volunteers.Methods: Blood form healthy volunteers was incubated for 4 hours with E. coli endotoxin to stimulate cytokine production. Cytokine containing blood was then circulated through a dialysis circuit at 3 different dialysate flow rates. Blood and dialysate were sampled for cytokine and albumin measurements and calculation of clearances.Results: Super high-flux dialysis achieved high median cytokine clearances (IL-1 clearance of 106 ml/min, IL-6 clearance of 66.8 ml/min, IL-8 clearance of 61.7 ml/min and TNF clearance of 36.1 ml/min). Increasing dialysate flow rate from 300 to 500 ml/min did not significantly increase cytokine clearances. Albumin clearances however were between 2.7 and 5.4 ml/min.Conclusions: Cytokine dialysis is feasible at high dialysate flow rates yielding high cytokine clearances. Albumin loss, however, is appreciable and may require separate supplementation in the clinical setting.