PMID- 11979349
OWN - NLM
STAT- MEDLINE
DCOM- 20020620
LR  - 20131121
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Linking)
VI  - 39
IP  - 5
DP  - 2002 May
TI  - Dialyzer fiber bundle volume and kinetics of solute removal in continuous 
      venovenous hemodialysis.
PG  - 1047-53
AB  - The relationship between dialyzer fiber bundle volume (FBV), dialyzer life span, 
      and small-solute clearance has yet to be clearly defined in continuous venovenous 
      hemodialysis (CVVHD). This study sought to define this relationship using novel 
      ultrasound dilution technology. We studied 55 sessions in 31 intensive care unit 
      patients on CVVHD therapy. A session was defined as the life span of a single 
      dialyzer. The following variables were assessed every 6 hours throughout each 
      session, starting within 1 hour of initiation of that session: FBV, access 
      recirculation, extracorporeal blood flow rate, effluent (EUN) to blood urea 
      nitrogen (BUN) concentration ratio, effluent creatinine to blood creatinine 
      concentration ratio, and urea nitrogen and creatinine clearances. Data were 
      analyzed using random-effects linear models to estimate trends. Several 
      dialysis-related and solute-removal parameters were analyzed for association with 
      each other. Systemic or dialysis circuit heparin was administered in 28 of 55 
      sessions. One hundred seventy sets of FBV, 101 sets of urea clearance, and 102 
      sets of creatinine clearance measurements were performed. There was a declining 
      trend for FBV (0.8 mL/h), heart rate (0.25 beats/min/h), and measured blood flow 
      (0.33 mL/min/h; P < 0.05). Apart from dialysate inflow rate (P = 0.044), there 
      was no significant correlation with EUN-BUN ratio. Session duration was 
      associated with dialysis access site; the femoral access provided longer dialysis 
      sessions than subclavian and internal jugular accesses (P = 0.029). We conclude 
      that small-solute removal remains stable over the course of our CVVHD system life 
      spans despite significant loss of hemodialyzer FBV.
CI  - Copyright 2002 by the National Kidney Foundation, Inc.
FAU - Liangos, Orfeas
AU  - Liangos O
AD  - Department of Nephrology/Hypertension, Cleveland Clinic Foundation, Cleveland, OH 
      44195, USA.
FAU - Sakiewicz, Paul G
AU  - Sakiewicz PG
FAU - Kanagasundaram, Nigel S
AU  - Kanagasundaram NS
FAU - Hammel, Jeff
AU  - Hammel J
FAU - Pajouh, Mehdi
AU  - Pajouh M
FAU - Seifert, Tracy
AU  - Seifert T
FAU - Paganini, Emil P
AU  - Paganini EP
LA  - eng
GR  - DK 54556-01/DK/NIDDK NIH HHS/United States
GR  - R01 DK 53411-01/DK/NIDDK NIH HHS/United States
GR  - R01 DK 53411-02/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
RN  - 0 (Hemodialysis Solutions)
RN  - 8W8T17847W (Urea)
RN  - AYI8EX34EU (Creatinine)
RN  - N762921K75 (Nitrogen)
SB  - IM
MH  - Blood Urea Nitrogen
MH  - Creatinine/blood/metabolism
MH  - Hemodialysis Solutions/analysis/metabolism
MH  - Hemofiltration/*instrumentation/*methods/statistics & numerical data
MH  - Humans
MH  - Kidney Failure, Chronic/blood/therapy
MH  - Kinetics
MH  - Metabolic Clearance Rate/physiology
MH  - Monitoring, Physiologic/instrumentation/methods/statistics & numerical data
MH  - Nitrogen/metabolism
MH  - Renal Circulation/physiology
MH  - Signal Processing, Computer-Assisted/instrumentation
MH  - Urea/metabolism
EDAT- 2002/04/30 10:00
MHDA- 2002/06/21 10:01
CRDT- 2002/04/30 10:00
PHST- 2002/04/30 10:00 [pubmed]
PHST- 2002/06/21 10:01 [medline]
PHST- 2002/04/30 10:00 [entrez]
AID - S0272-6386(02)10644-5 [pii]
AID - 10.1053/ajkd.2002.32788 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 2002 May;39(5):1047-53. doi: 10.1053/ajkd.2002.32788.