The Emboless® venous chamber efficiently reduces air bubbles: a randomized study of chronic hemodialysis patients.

IF 3.9 2区医学 Q1 UROLOGY & NEPHROLOGY

Clinical Kidney Journal Pub Date : 2024-10-24 eCollection Date: 2024-11-01 DOI:10.1093/ckj/sfae323

Ulf Forsberg, Per Jonsson, Bernd Stegmayr

{"title":"The Emboless® venous chamber efficiently reduces air bubbles: a randomized study of chronic hemodialysis patients.","authors":"Ulf Forsberg, Per Jonsson, Bernd Stegmayr","doi":"10.1093/ckj/sfae323","DOIUrl":null,"url":null,"abstract":"Background: When blood passes the extracorporeal circuit, air microbubbles (MBs) contaminate the blood. Some MBs will end up as microemboli in the lung, heart, and brain. MB exposure has no medical purpose and is considered to be bio-incompatible. Selecting venous chambers with a high removal rate of MBs is warranted to reduce the risks of air bio-incompatibility. The primary aim was to compare the Fresenius 5008 (F5008-VC) and the Emboless® (Emboless-VC) venous chambers regarding the elimination of MBs in the return bloodline during hemodialysis (HD).Methods: Twenty patients underwent 80 sessions of cross-over HD using both the F5008-VC and the Emboless-VC randomized such that half started with the F5008-VC and half with the Emboless-VC. For 32 of the 80 sessions, measurements were also performed during hemodiafiltrations (HDF) after the initial HD. MBs were measured with an ultrasound device (within the size range of 20-500 µm) at the \"inlet\" and \"outlet\" bloodline of the venous chambers. The Wilcoxon pairwise test compared the percentage of MB elimination between venous chambers.Results: During HD, the median reduction of MBs for the outlet was 39% with the F5008-VC and 76% with the Emboless-VC (P < .001). During HDF, the reduction was 28% with the F5008-VC and 70% with the Emboless-VC (P < .001).Conclusion: Fewer MBs and subsequently fewer microemboli entered the bloodline of the patient using the Emboless-VC compared to the F5008-VC venous chamber during HD and during HDF. Venous chambers with a high removal rate of MBs will reduce the extent of air emboli.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 11","pages":"sfae323"},"PeriodicalIF":3.9000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579606/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Kidney Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ckj/sfae323","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: When blood passes the extracorporeal circuit, air microbubbles (MBs) contaminate the blood. Some MBs will end up as microemboli in the lung, heart, and brain. MB exposure has no medical purpose and is considered to be bio-incompatible. Selecting venous chambers with a high removal rate of MBs is warranted to reduce the risks of air bio-incompatibility. The primary aim was to compare the Fresenius 5008 (F5008-VC) and the Emboless^® (Emboless-VC) venous chambers regarding the elimination of MBs in the return bloodline during hemodialysis (HD).

Methods: Twenty patients underwent 80 sessions of cross-over HD using both the F5008-VC and the Emboless-VC randomized such that half started with the F5008-VC and half with the Emboless-VC. For 32 of the 80 sessions, measurements were also performed during hemodiafiltrations (HDF) after the initial HD. MBs were measured with an ultrasound device (within the size range of 20-500 µm) at the "inlet" and "outlet" bloodline of the venous chambers. The Wilcoxon pairwise test compared the percentage of MB elimination between venous chambers.

Results: During HD, the median reduction of MBs for the outlet was 39% with the F5008-VC and 76% with the Emboless-VC (P < .001). During HDF, the reduction was 28% with the F5008-VC and 70% with the Emboless-VC (P < .001).

Conclusion: Fewer MBs and subsequently fewer microemboli entered the bloodline of the patient using the Emboless-VC compared to the F5008-VC venous chamber during HD and during HDF. Venous chambers with a high removal rate of MBs will reduce the extent of air emboli.

查看原文本刊更多论文

Emboless® 静脉腔能有效减少气泡：一项针对慢性血液透析患者的随机研究。

背景：当血液通过体外循环时，空气微泡（MBs）会污染血液。一些微泡最终会在肺部、心脏和脑部形成微栓子。微气泡暴露没有医疗用途，被认为与生物不相容。因此，有必要选择甲基溴去除率高的静脉腔，以降低空气生物不相容的风险。主要目的是比较费森尤斯5008（F5008-VC）和Emboless®（Emboless-VC）静脉腔在血液透析（HD）过程中清除回血管中甲基溴的情况：20名患者同时使用F5008-VC和Emboless-VC进行了80次交叉血液透析，随机安排一半患者使用F5008-VC，一半患者使用Emboless-VC。在 80 个疗程中，有 32 个疗程在初始 HD 后的血液滤过 (HDF) 期间也进行了测量。使用超声设备在静脉腔的 "入口 "和 "出口 "血线处测量 MB（尺寸范围为 20-500 微米）。通过 Wilcoxon 配对检验比较了不同静脉腔的 MB 清除率：结果：在血液透析过程中，使用 F5008-VC 和 Emboless-VC 时，出口处 MBs 减少的中位数分别为 39% 和 76% （P P 结论）：在 HD 和 HDF 期间，与 F5008-VC 静脉腔相比，使用 Emboless-VC 的 MB 更少，因此进入患者血液的微栓子也更少。具有高 MB 清除率的静脉腔室将减少空气栓塞的程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Kidney Journal Medicine-Transplantation

CiteScore

6.70

自引率

10.90%

发文量

242

审稿时长

8 weeks

期刊介绍： About the Journal Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.