title: Optimum Conditions for the Efficacy and Safety of Cryofiltration Apheresis: An Analysis of Circuit Temperatures Depending on Plasma Flow Rate and Cooling Coil Lengths/Turns.
abstract: A system providing both appropriate cooling and warming are needed for the efficacy and safety of cryofiltration (CF) plasmapheresis. We measured some points of CF circuit temperatures with varying plasma flow rates (QP  = 10-40 mL/min) and the numbers of connecting cooling coils (one or two) under the conditions of blood flow rate (QB ) 100 mL/min with 7700-mm coil length, 19 turns, and 50-mL priming volume. We measured the respective temperatures of each point of starting/returning for an extracorporeal circuit (TA /TV ), intracooling coil (TC ), and post-plasma fractionator (PF) (TPF ). The subtraction of TV from TA (ΔT) was used as an indicator of safe return. There were no significant differences in TC , TPF , or ΔT in accordance with each QP between that of one and two coils. All of the Tc values under the condition QP  ≤ 20 mL/min achieved <4°C. The TPF under the condition QP  ≥ 20 mL/min was not significantly different compared to that of QP 30 mL/min (the lowest condition). Although the ΔT increased depending on the QP increase, the ΔT under the condition QP  ≤ 15 mL/min was not significantly different from that of the control (one-way double-filtration plasmapheresis [DFPP]) group. We conclude that (i) one coil is enough for effective cooling in CF, and (ii) an ideal QP that fulfills the required conditions for both effective cooling and sufficient warming of returning fluid does not exist, but QP from 15 to 20 mL/min may be a relevant range.
authors.affiliation: Department of Clinical Engineering, Itabashi Chuo Medical Center, Itabashi, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakajima
authors.affiliation: Department of Nephrology, Itabashi Chuo Medical Center, Itabashi, Japan.
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kaneko
authors.affiliation: Department of Clinical Engineering, Itabashi Chuo Medical Center, Itabashi, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Clinical Engineering, Itabashi Chuo Medical Center, Itabashi, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Takano
authors.affiliation: Department of Clinical Engineering, Itabashi Chuo Medical Center, Itabashi, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Hosino
mesh_terms: D003080:Cold Temperature; D003450:Cryoglobulins / Q000009:adverse effects; D004867:Equipment Design; D005374:Filtration / Q000379:methods; D006801:Humans; D061214:Patient Safety; D010956:Plasmapheresis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results; D056647:Systemic Vasculitis / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D003450:Cryoglobulins
keywords: Circuit temperature; Cooling coil lengths/turns; Cryofiltration; Efficacy and safety; Plasma flow rate