Hemofiltration system for the post traumatic treatment of hyperkalemia in austere conditions

IF 2.2 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2024-12-13 DOI:10.1111/aor.14919

Meredith Haanstad, Leslie D. Seeley, Tara Srinivas, Matthew Chamot, Trevor Haanstad, Christopher Marotta, Palaniappan Sethu, Ambalavanan Jayaraman

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Abstract

Background

Hyperkalemia, the buildup of serum potassium to levels >6 mEq L⁻¹, has been a recognized complication of combat injuries such as acute kidney injury since World War II. Currently, renal replacement therapy (RRT) serves as the standard of care for hyperkalemic patients who fail to respond to medical management. However, RRT is difficult to administer in combat settings, and the time between evacuation and RRT is critical in preventing post-traumatic hyperkalemia. Therefore, the need for portable, easily operable hemofiltration technology is pressing to improve the survival of hyperkalemic patients in austere settings.

Methods

In this manuscript, we present extra-corporeal direct contact and hemodialysis filtration systems for treating severe hyperkalemia and tested the efficacy, biocompatibility, and performance of a zeolite-based renal RRT. We tested the uptake capacity of an adsorbent zeolite optimized for the selective binding and removal of potassium in various mediums, including dialysate, bovine serum, and whole bovine sodium heparinized blood.

Results and Conclusions

Our results show that we can restore physiological normokalemic levels within just 2 h of testing and maintain these levels for 6 h. Furthermore, calcium and sodium levels were maintained within normal physiological ranges, confirming the selectivity of our sorbent material for potassium binding.

Abstract Image

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血液滤过系统创伤后治疗高钾血症在严峻的条件。

背景：自二战以来，高钾血症，即血清钾积累至6meq L-1水平，一直是战斗损伤（如急性肾损伤）的公认并发症。目前，肾脏替代疗法（RRT）是治疗高钾血症患者的标准治疗方法。然而，RRT很难在战斗环境中实施，疏散和RRT之间的时间对于预防创伤后高钾血症至关重要。因此，迫切需要便携式、易于操作的血液滤过技术，以提高高钾血症患者在严峻环境下的生存率。方法：在这篇文章中，我们提出了用于治疗严重高钾血症的体外直接接触和血液透析过滤系统，并测试了沸石基肾RRT的疗效、生物相容性和性能。我们测试了一种吸附沸石的吸收能力，这种沸石被优化为在各种介质中选择性结合和去除钾，包括透析液、牛血清和全牛肝素化钠血。结果和结论：我们的研究结果表明，我们可以在测试的2小时内恢复生理的等钾水平，并将这些水平维持6小时。此外，钙和钠水平保持在正常的生理范围内，证实了我们的吸附材料对钾结合的选择性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.