TY - JOUR
T1 - Predilution versus postdilution during continuous venovenous hemofiltration: a comparison of circuit thrombogenesis
AU - de Pont, Anne-Cornélie J. M.
AU - Bouman, Catherine S. C.
AU - Bakhtiari, Kamran
AU - Schaap, Marianne C. L.
AU - Nieuwland, Rienk
AU - Sturk, Augueste
AU - Hutten, Barbara A.
AU - de Jonge, Evert
AU - Vroom, Margreeth B.
AU - Meijers, Joost C. M.
AU - Büller, Harry R.
PY - 2006
Y1 - 2006
N2 - During continuous venovenous hemofiltration, predilution can prolong circuit survival time, but the underlying mechanism has not been elucidated. The aim of the present study was to compare predilution with postdilution, with respect to circuit thrombogenesis. Eight critically ill patients were treated with both predilutional and postdilutional continuous venovenous hemofiltration in a crossover fashion. A filtration flow of 60 ml/min was used in both modes. We chose blood flows of 140 and 200 ml/min during predilution and postdilution, respectively, to keep the total flow through the hemofilter constant. Extracorporeal circuit pressures were measured hourly, and samples of blood and ultrafiltrate were collected at five different time points. Thrombin-antithrombin complexes and prothrombin fragments F1 + 2 were measured by ELISA, and platelet activation was assessed by flow cytometry. No signs of thrombin generation or platelet activation were found during either mode. During postdilution, baseline platelet count and maximal prefilter pressure had a linear relation, whereas both parameters were inversely related with circuit survival time.In summary, predilution and postdilution did not differ with respect to extracorporeal circuit thrombogenesis. During postdilution, baseline platelet count and maximal prefilter pressure were inversely related with circuit survival time
AB - During continuous venovenous hemofiltration, predilution can prolong circuit survival time, but the underlying mechanism has not been elucidated. The aim of the present study was to compare predilution with postdilution, with respect to circuit thrombogenesis. Eight critically ill patients were treated with both predilutional and postdilutional continuous venovenous hemofiltration in a crossover fashion. A filtration flow of 60 ml/min was used in both modes. We chose blood flows of 140 and 200 ml/min during predilution and postdilution, respectively, to keep the total flow through the hemofilter constant. Extracorporeal circuit pressures were measured hourly, and samples of blood and ultrafiltrate were collected at five different time points. Thrombin-antithrombin complexes and prothrombin fragments F1 + 2 were measured by ELISA, and platelet activation was assessed by flow cytometry. No signs of thrombin generation or platelet activation were found during either mode. During postdilution, baseline platelet count and maximal prefilter pressure had a linear relation, whereas both parameters were inversely related with circuit survival time.In summary, predilution and postdilution did not differ with respect to extracorporeal circuit thrombogenesis. During postdilution, baseline platelet count and maximal prefilter pressure were inversely related with circuit survival time
U2 - https://doi.org/10.1097/01.mat.0000227733.03278.5f
DO - https://doi.org/10.1097/01.mat.0000227733.03278.5f
M3 - Article
C2 - 16883122
SN - 1058-2916
VL - 52
SP - 416
EP - 422
JO - ASAIO journal (American Society for Artificial Internal Organs
JF - ASAIO journal (American Society for Artificial Internal Organs
IS - 4
ER -