Differences in chamber structure contribute to the incidence of venous air trap chamber coagulation during AN69ST-CHF: clinical and in vitro evaluation

Autor: Kota Shimizu, Kazuhiro Moriyama, Naohide Kuriyama, Tomoyuki Nakamura, Takahiro Kawaji, Satoshi Komatsu, Osamu Nishida
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Renal Replacement Therapy, Vol 10, Iss 1, Pp 1-9 (2024)
Druh dokumentu: article
ISSN: 2059-1381
DOI: 10.1186/s41100-024-00526-2
Popis: Abstract Background During continuous kidney replacement therapy (CKRT) in patients with sepsis and critical conditions, circuit coagulation can occur, often for unclear reasons. In this study, we investigate how the structure of the venous air trap chamber may contribute to venous air trap chamber coagulation. Clinical data were evaluated and experiments were performed. Methods The clinical evaluation involved patients who underwent continuous hemofiltration (CHF) using an acrylonitrile-co-methallyl sulfonate surface-treated (AN69ST) hemofilter (AN69ST-CHF) and either an ACH-Σ or Prismaflex CKRT machine in our ICU from April to July 2019. The patient data were divided into two groups based on CKRT machine and the percentage of CHF procedures that could continuously be performed for 22 h (CHF target achievement rate), and coagulation sites were evaluated. Statistical analysis was performed by the Mann–Whitney U test and Pearson’s chi-square test. For in vitro experiments, a system was constructed to circulate a 33% glycerol solution at a flow rate of 150 ml/min. In a venous air trap chamber, fluid dye disappearance times and fluid movements were visually evaluated. Results The clinical evaluation included 22 procedures (8 patients) in the ACH-Σ group and 22 procedures (11 patients) in the Prismaflex group, without significant differences in patient backgrounds between the groups. The CHF target achievement rate was 72.7% (16/22) in the ACH-Σ group and 77.3% (17/22) in the Prismaflex group, revealing no significant difference (p = 0.73). However, significantly fewer venous air trap chamber coagulations were observed in the Prismaflex group (1/5) than in the ACH-Σ group (5/6) (p
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