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Membranes and Filters for use in Acute RRT

Membranes and Filters for use in Acute RRT. April 26 , 2012. Modality of ARRT with Efficiency Defined. Marshall MR, Golper TA:Semin Dial 24:142-148,2011. Artificial Kidney for RRT. 人工腎臟的特性. 透析膜 材質、面積大小 超過濾係數 (UFR) 與篩濾係數 (SC) 清除率 中空纖維 (Hollow Fiber) 幾何結構 膜厚度、內徑大小、長度 消毒方法

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Membranes and Filters for use in Acute RRT

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  1. Membranes and Filters for use in Acute RRT April 26, 2012

  2. Modality of ARRT with Efficiency Defined Marshall MR, Golper TA:Semin Dial 24:142-148,2011

  3. Artificial Kidney for RRT

  4. 人工腎臟的特性 • 透析膜 • 材質、面積大小 • 超過濾係數(UFR)與篩濾係數(SC) • 清除率 • 中空纖維(Hollow Fiber)幾何結構 • 膜厚度、內徑大小、長度 • 消毒方法 • 內毒素的阻隔能力

  5. Categories for HD membranes Vicken J. Membranes in Haemodialysis in；Peinemann KV, Pereira Nunes SP, (eds) Membranes for Life Sciences. Wiley Co, 2007；1-48.

  6. Dialyzer membranes for RRT in AKI 2012 KDIGO guideline for AKI

  7. Agenda Modality of ARRT Artificial Kidney for RRT 血液透析器設計理念 血液過濾器設計理念 血液透析過濾器 for SLEDD-f

  8. 血液透析器 for IHD Chronic Filter 200 µm 40 µm

  9. Agenda Modality of ARRT Artificial Kidney for RRT 血液透析器設計理念 血液過濾器設計理念 血液透析過濾器 for SLEDD-f

  10. “理想的" 血液過濾（Hemofilter） • 具高生物相容性 • 具良好的中大分子篩濾與清除效果 • 抗凝劑需要量越低越好 • 最少可連續使用24小時

  11. “理想的" 血液過濾器 • Fuction • Membrane permeability • Diffusion Low and High flux • Convention High Hlux • Filter and Fiber Geometry • Adapted for low blood flow • Large ID：short • Biocompatibility

  12. 血液過濾器 – 中空纖維特性 Membrane geometry adapted to special needs in CRRT • Decreased wall thickness • increased diffusive clearance • Increased inner lumen • less shear-stress • lower thrombogenicity • lower heparin need Acute Filter 35 µm 220 µm

  13. Agenda Modality of ARRT Artificial Kidney for RRT 血液透析器設計理念 血液過濾器設計理念 血液透析過濾器 for SLEDD-f

  14. S i e v i n g C o e f f i c i e n t 1 , 0 0 , 8 S t a n d a r d m e m b r a n e P o l y s u l f o n e Ultra - F l u x K i d n e y 0 , 6 0 , 4 0 , 2 0 100 1000 100000 10000 10 I n u l i n ß 2 - M A l b u m i n V i t . B U r e a C r e a t i n i n e 1 2 M o l e c u l a r W e i g h t [ D a l t o n ] high-flux dialyser is required to SLEDD-f • A high-flux dialyser is required to perform SLEDD-f • A dialysis membrane with high hydraulic permeability, high solute permeability and large surface exchange • Moderate transmembrane pressures (< 300mmHg) • Simultaneously avoid or minimal albumin loss • Highly biocompatible membrane is particular importance The cut off of the membrane is ~ 30.000 Dalton.

  15. “Hybrid” Hospital Regimens • Extended daily (dialysis) filtration regimens at six hospitals Extended Daily Dia-filtration / 5008 / 5008 Mark R. Marshall R. Bellomo New York, USA Hannover, Germany Arkansas, USA Auckland, New Zealand Goldcoast, Australia

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