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Bellco srl Lynda CRRT machine CVVH PEX & CPFA Presentation

Bellco srl Lynda CRRT machine CVVH PEX & CPFA Presentation. Versatile for the physician, functional for the nurse, effective for the patient . A simple answer to complex questions from the Abyle line. Therapeutic versatility. Wide range of options.

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Bellco srl Lynda CRRT machine CVVH PEX & CPFA Presentation

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  1. Bellco srlLynda CRRT machineCVVH PEX & CPFA Presentation

  2. Versatile for the physician, functional for the nurse, effective for the patient. A simple answer to complex questions from the Abyle line

  3. Therapeutic versatility • Wide range of options Technological innovation, the wide range of therapies and ease of use are the essential features of Lynda

  4. Therapeutic versatility • Wide range of options • Continual monitoring of hematocrit and oxygen saturation The HCT (with blood volume calculation) and the SO2can directly and continuously be measured through a high-precision instrument (closed system with cuvette integrated in the arterial line). A sensor measures a physical quantity. An application interprets the measurement and gives it a clinical meaning

  5. Therapeutic versatility • Wide range of options • Continual monitoring of hematocrit and oxygen saturation • Program the infusion system in pre-dilution, post-dilution, or pre-post dilution simultaneously

  6. Therapeutic versatility • Wide range of options • Continual monitoring of hematocrit and oxygen saturation • Program the infusion system in pre-dilution, post-dilution, or pre-post dilution simultaneously • Filtration fraction control (ff).

  7. Therapeutic versatility • Wide range of options • Continual monitoring of hematocrit and oxygen saturation • Program the infusion system in pre-dilution, post-dilution, or pre-post dilution simultaneously • Filtration fraction control (ff). • History file (over 300 hours capacity). • The most important information on the therapies performed, the clinical parameter settings, the pressure and infused fluid volume graphs

  8. Functionality ·Automatic priming in all treatment methods.

  9. Functionality ·Automatic priming in all treatment methods. ·On-line guide for the operator to check all the sequences “instant by instant”.

  10. Functionality ·Automatic priming in all treatment methods. ·On-line guide for the operator to check all the sequences “instant by instant”. • High-visibility display with user-friendly and intuitive touch screen interface, which allows clear, fast and direct dialogue with the machine.

  11. Functionality ·Automatic priming in all treatment methods. ·On-line guide for the operator to check all the sequences “instant by instant”. • High-visibility display with user-friendly and intuitive touch screen interface, which allows clear, fast and direct dialogue with the machine. • Autonomy of 40 litres of controlled exchange between two scales, saving time and reducing the possibility of error

  12. Effectiveness Bicompartmental bag: The bag is composed of two separate compartments: one for the bicarbonate buffer (5000 mL) and the other for the electrolytes (500 mL). The contents are mixed just before use. Two simple operations allow obtaining a solution that remains stable up to 24 hours: - Breakage of the septum separating the two compartments • Brief agitation to encourage mixing and obtain a homogeneous solution.

  13. Effectiveness • The disposable Plug & Play system, comprising preconnected filter/s and lines for all the treatment methods, simplifies and speeds up the installation operations and reduces the possibility of error.

  14. SCUF(SLOW CONTINUOUS ULTRAFILTRATION) Uf EMOFILTRO

  15. CVVH, IHF-HVHF(CONTINUOUS VENO-VENOUS HEMOFILTRATION, INTERMITTENT HEMO FILTRATION – HIGH VOLUME HEMOFILTRATION, SINGLE NEEDLE HEMOFILTRATION) Post diluizione (20:100%) Uf EMOFILTRO Infusione o anticoagulante Pre diluizione (0:80%)

  16. SN HF(SINGLE NEEDLE HEMOFILTRATION) Uf EMOFILTRO Infusione o anticoagulante

  17. PEX (PLASMA EXCHANGE) Liquido di sostituzione Post diluizione Plasma PLASMAFILTRO

  18. p p p p p p p CPFA anticoagulante

  19. Effectiveness • Disposable Plug & Play • CPFA: a targeted response to sepsis

  20. Infection Inflammatory response to microorganisms, or Invasion of normally sterile tissues Systemic Inflammatory Response Syndrome (SIRS) Systemic response to a variety of processes Sepsis Infection plus 2 SIRS criteria Severe Sepsis Sepsis Organ dysfunction Septic shock Sepsis Hypotension despite fluid resuscitation Multiple Organ Dysfunction Syndrome (MODS) Altered organ function in an acutely ill patient Homeostasis cannot be maintained without intervention What is Sepsis ?ACCP/SCCM Consensus Definitions Bone RC et al. Chest. 1992;101:1644-55.

  21. Therapeutic Strategies Systemic inflammatory response Multi-organ dysfunction Infection Endothelial Dysfunction Cell activation • Eliminate infection • antibiotics • Reduce systemic reaction • Steroids • Insulin (glucose control) • Xigris • Support organs • Ventilation • CRRT • IV fluids • Vasopressors

  22. Coupled Plasma Filtration Adsorption Plasma UF out reinfusion in

  23. Therapeutic goal Separate and retain “toxins”from a complex mixture Time = 0 later “toxins” Physiological“good” molecules

  24. Ideal therapy for sepsis Plasma “bad molecules” “good molecules” Dialysate out Dialysate in

  25. Interleukin 1b Interleukin 5 Interleukin 6 Interleukin 7 Interleukin 8 Interleukin 10(?) Interleukin 12p70 Interleukin 16 Interleukin 18 Macrophage inflammatory protein-a (MIP-a) Macrophage inflammatory protein-b (MIP-b) Tumor necrosis factor-aTNF-a Monocyte chemotactic protein (MCP-1) RANTES Epithelial neutrophil activating peptide 78 (ENA-78) Angiogenin What can the CPFA resin adsorb?

  26. CPFA used successfully in non-ARF patients Hemodynamic response to coupled plasmafiltration-adsorption in human septic shock Marco Formica, Carlo Olivieri, Sergio Livigni, Giulio Cesano, Antonella Vallero, Mariella Maio and Ciro Tetta Intensive Care Med (2003) 29: 703-708 Objective: The objective was to examine the effect of repeated applications of coupled plasmafiltration-adsorption on the hemodynamic response in septic shock patients hospitalized in intensive care units (ICUs). Conclusion: Coupled plasmafiltration-adsorption was a feasible and safe extracorporeal treatment and exerted a remarkable improvement in the hemodynamics, the pulmonary function, and the outcome in septic shock patients with or without concomitant ARF.

  27. What is not adsorbed to the resin • No significant adsorption of • Albumin • Heparin • Citrate • Antibodies • Ferritin • GM-CSF • Thyroxine • Adiponectin • Von Willebrand factor • Endotoxin • Low Adsorption • Insulin (1st hour) • VEGF • EGF • ICAM • VCAM • MCP

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