Development of a new antithrombogenic continuous ultrafiltration system (ACUS) and its clinical evaluation.
A new totally antithrombogenic continuous ultrafiltration system (ACUS), consisting of polyacrylonitrile-polyethyleneoxide (PAN-PEO) membrane and ionically heparin-bound catheter, tubing, and module header was designed and its performance was confirmed through animal experiments and clinical evaluation. Animal experiments revealed that persistent antithrombogenicity and maintained ultrafiltration without systemic heparinisation were observed only when the three major parts--i.e. (1) the catheter and tubing, (2) the header part of a haemofilter module, and (3) the fibre membrane--were all antithrombogenic and connected to each other without uneven structures. ACUS was clinically applied to 15 oliguric patients with various severe conditions. We found that one filter could function for approximately 26 h without systemic anticoagulation, even in the presence of low blood pressure, and that ACUS did not change platelet function. Thus, ACUS seems to be very suitable for the management of volume overload, especially in patients with severe circulatory problems or bleeding tendencies.
Arakawa
M
M
Department of Medicine (II), Niigata University School of Medicine, Japan.
Suzuki
Y
Y
Nagao
M
M
Aoike
I
I
Koda
Y
Y
Terada
R
R
Kunitomo
T
T
D000180:Acrylic Resins / Q000494:pharmacology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D004285:Dogs; D005112:Extracorporeal Circulation; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000494:pharmacology; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D014462:Ultrafiltration / Q000295:instrumentation / Q000379:methods*
D000180:Acrylic Resins; D005343:Fibrinolytic Agents; C010504:polyacrylonitrile; D011092:Polyethylene Glycols; D003404:Creatinine