High-efficiency, high-flux in-line hemofiltration using a high blood flow extracorporeal circuit.

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  • Additional Information
    • Affiliation:
      Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
      Division of Renal-Electrolyte and Hypertension, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
      R Adams Cowley Shock Trauma Center and Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
      Retired Mechanical Engineer, Farmington Hills, MI, USA
      Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
      Department of Medicine, School of Pharmacy and Maryland Poison Center, University of Maryland School of Medicine, Baltimore, MD, USA
      Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
      Univeristy of Maryland Medical Center, Baltimore, MD, USA
      Department of Medicine and Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      The ability of current renal replacement therapy modalities to achieve rapid solute removal is limited by membrane surface area and blood flow rate. Extracorporeal membrane oxygenation offers high blood flow and hemodynamic support that may be harnessed to overcome limitations in traditional renal replacement therapy. Using an extracorporeal membrane oxygenation circuit, we describe a high blood flow, high-efficiency hemofiltration technique using in-line hemofilters (hemoconcentrators) and standard replacement fluid to enhance solute clearance. Using this approach and a total of 5 L of replacement volume per treatment, creatinine (Cr) clearances of 8.3 L/hour and 11.2 L/hour using one and two hemoconcentrators, respectively, were achieved. With use of a high blood flow rate of up to 5 L/min, this hemofiltration technique can potentially offer clearance of 30 times that of continuous renal replacement therapy and of 6 times that of hemodialysis which may expand the ability to remove substances traditionally not considered removable via existing extracorporeal therapies.
    • Journal Subset:
      Allied Health; Double Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
    • ISSN:
      0267-6591
    • MEDLINE Info:
      NLM UID: 8700166
    • Publication Date:
      20200602
    • Publication Date:
      20200604
    • DOI:
      http://dx.doi.org/10.1177/0267659119871232
    • Accession Number:
      143498155
  • Citations
    • ABNT:
      GRAZIOLI, A. et al. High-efficiency, high-flux in-line hemofiltration using a high blood flow extracorporeal circuit. Perfusion, [s. l.], v. 35, n. 4, p. 351–355, 2020. DOI 10.1177/0267659119871232. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143498155. Acesso em: 14 ago. 2020.
    • AMA:
      Grazioli A, Shah SR, Rabin J, et al. High-efficiency, high-flux in-line hemofiltration using a high blood flow extracorporeal circuit. Perfusion. 2020;35(4):351-355. doi:10.1177/0267659119871232
    • APA:
      Grazioli, A., Shah, S. R., Rabin, J., Shah, R., Madathil, R. J., King, J. D., DiChiacchio, L., Rector, R. P., Deatrick, K. B., Wu, Z. J., & Herr, D. L. (2020). High-efficiency, high-flux in-line hemofiltration using a high blood flow extracorporeal circuit. Perfusion, 35(4), 351–355. https://doi.org/10.1177/0267659119871232
    • Chicago/Turabian: Author-Date:
      Grazioli, Alison, Sanjeev R Shah, Joseph Rabin, Rashmikant Shah, Ronson J Madathil, Joshua D King, Laura DiChiacchio, et al. 2020. “High-Efficiency, High-Flux in-Line Hemofiltration Using a High Blood Flow Extracorporeal Circuit.” Perfusion 35 (4): 351–55. doi:10.1177/0267659119871232.
    • Harvard:
      Grazioli, A. et al. (2020) ‘High-efficiency, high-flux in-line hemofiltration using a high blood flow extracorporeal circuit’, Perfusion, 35(4), pp. 351–355. doi: 10.1177/0267659119871232.
    • Harvard: Australian:
      Grazioli, A, Shah, SR, Rabin, J, Shah, R, Madathil, RJ, King, JD, DiChiacchio, L, Rector, RP, Deatrick, KB, Wu, ZJ & Herr, DL 2020, ‘High-efficiency, high-flux in-line hemofiltration using a high blood flow extracorporeal circuit’, Perfusion, vol. 35, no. 4, pp. 351–355, viewed 14 August 2020, .
    • MLA:
      Grazioli, Alison, et al. “High-Efficiency, High-Flux in-Line Hemofiltration Using a High Blood Flow Extracorporeal Circuit.” Perfusion, vol. 35, no. 4, May 2020, pp. 351–355. EBSCOhost, doi:10.1177/0267659119871232.
    • Chicago/Turabian: Humanities:
      Grazioli, Alison, Sanjeev R Shah, Joseph Rabin, Rashmikant Shah, Ronson J Madathil, Joshua D King, Laura DiChiacchio, et al. “High-Efficiency, High-Flux in-Line Hemofiltration Using a High Blood Flow Extracorporeal Circuit.” Perfusion 35, no. 4 (May 2020): 351–55. doi:10.1177/0267659119871232.
    • Vancouver/ICMJE:
      Grazioli A, Shah SR, Rabin J, Shah R, Madathil RJ, King JD, et al. High-efficiency, high-flux in-line hemofiltration using a high blood flow extracorporeal circuit. Perfusion [Internet]. 2020 May [cited 2020 Aug 14];35(4):351–5. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143498155