Contemporary means for extra-renal blood purification used abroad

Kozlov, Yu. G.; Lisitsina, G. K.; Khaitlin, A. I.

doi:10.1007/bf00568676

Cited by 1 publication

(1 citation statement)

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“…TMP was the main parameter that allowed the pioneers in dialysis to control ultrafiltration and thereby weight loss and extracellular volume. With the advent of ultrafiltration controllers [ 13 ], weight loss was accurately driven by automatic setting of TMP by dialysis monitors. TMP turned into an informative value and lost its protagonism.…”

Section: Discussionmentioning

confidence: 99%

Measuring intradialyser transmembrane and hydrostatic pressures: pitfalls and relevance in haemodialysis and haemodiafiltration

Ficheux

Gayrard

Szwarc³

et al. 2019

Clinical Kidney Journal

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Background Post-dilutional haemodiafiltration (HDF) with high convection volumes (HCVs) could improve survival. HCV-HDF requires a significant pressure to be applied to the dialyser membrane. The aim of this study was to assess the pressure applied to the dialysers in HCV-HDF, evaluate the influence of transmembrane pressure (TMP) calculation methods on TMP values and check how they relate to the safety limits proposed by guidelines. Methods Nine stable dialysis patients were treated with post-dilutional HCV-HDF with three different convection volumes [including haemodialysis (HD)]. The pressures at blood inlet (Bi), blood outlet (Bo) and dialysate outlet (Do) were continuously recorded. TMP was calculated using two pressures (TMP2: Bo, Do) or three pressures (TMP3: Bo, Do, Bi). Dialysis parameters were analysed at the start of the session and at the end of treatment or at the first occurrence of a manual intervention to decrease convection due to TMP alarms. Results During HD sessions, TMP2 and TMP3 remained stable. During HCV-HDF, TMP2 remained stable while TMP3 clearly increased. For the same condition, TMP3 could be 3-fold greater than TMP2. This shows that the TMP limit of 300 mmHg as recommended by guidelines could have different effects according to the TMP calculation method. In HCV-HDF, the pressure at the Bi increased over time and exceeded the safety limits of 600 mmHg provided by the manufacturer, even when respecting TMP safety limits. Conclusions This study draws our attention to the dangers of using a two-pressure points TMP calculation, particularly when performing HCV-HDF.

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Section: Discussionmentioning

confidence: 99%