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Effects of Ultrafiltration, Dialysis, and Temperature on Gas Exchange During Hemodiafiltration: A Laboratory Experiment
Author(s) -
Ruzicka Jiri,
Novak Ivan,
Rokyta Richard,
Matejovic Martin,
Hadravsky Milan,
Nalos Marek,
Sramek Vladimir
Publication year - 2001
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1046/j.1525-1594.2001.06746.x
Subject(s) - ultrafiltration (renal) , dialysis , filtration (mathematics) , chemistry , volume (thermodynamics) , chromatography , bicarbonate , surgery , medicine , mathematics , statistics , organic chemistry , physics , quantum mechanics
To study gas exchange in the filter during continuous venovenous hemodiafiltration (CVVHDF), an air‐tight heated mixing chamber with adjustable CO 2 supply was constructed and connected to a CVVHDF monitor. Bicarbonate‐free crystalloid (Part 1) and packed red blood cell (Part 2) solutions were circulated at 150 ml · min −1 . Gas exchange expressed as pre‐postfilter difference in CO 2 and O 2 contents was measured at different CVVHDF settings and temperatures of circulating and dialysis solutions. Ultrafiltration was most efficacious for CO 2 removal (at 1,000 ml · h −1 ultrafiltration CO 2 losses reached 13% of prefilter CO 2 content). Addition of dialysis (1,000 ml · h −1 ) increased CO 2 loss to 17% and at maximal parameters (filtration 3,000 ml · h −1 , dialysis 2,500 ml · h −1 ), the loss of CO 2 amounted to 35% of prefilter content. Temperature changes of circulating and/or dialysis fluids had no significant impact on CO 2 losses. The O 2 exchange during CVVHDF was negligible. Currently used CVVHDF is only marginally effective in CO 2 removal. Higher volume ultrafiltration combined with dialysis can be expected to reach clinical significance.