A safe procedure for connecting a continuous renal replacement therapy device into an extracorporeal membrane oxygenation circuit

Patients receiving extracorporeal membrane oxygenation (ECMO) often require continuous renal replacement therapy (CRRT). The intra-circuit pressure of adult ECMO usually deviates from the physiological range. We investigated the use of CRRT connected to an ECMO circuit with physiological intra-circu...

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Bibliographic Details
Published in:Journal of artificial organs 2017-06, Vol.20 (2), p.125-131
Main Authors: Suga, Natsumi, Matsumura, Yosuke, Abe, Ryuzo, Hattori, Noriyuki, Nakada, Taka-aki, Oda, Shigeto
Format: Article
Language:English
Subjects:
Adult
Biomedical Engineering and Bioengineering
Bypasses
Cardiac Surgery
Circuits
Extracorporeal membrane oxygenation
Extracorporeal Membrane Oxygenation - methods
Humans
In vitro methods and tests
Kidney transplantation
Limbs
Medicine
Medicine & Public Health
Models, Biological
Nephrology
Original Article
Oxygenation
Patients
Physiology
Pressure
Renal Dialysis
Renal replacement therapy
Respiratory therapy
Safety
Surgical apparatus & instruments
Therapy
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Summary:Patients receiving extracorporeal membrane oxygenation (ECMO) often require continuous renal replacement therapy (CRRT). The intra-circuit pressure of adult ECMO usually deviates from the physiological range. We investigated the use of CRRT connected to an ECMO circuit with physiological intra-circuit pressures (0–150 mmHg, defined as the “safety range”) using an in vitro experiment involving a water-filled ECMO circuit. The intra-circuit pressure pre-pump, post-pump, and post-oxygenator were measured while varying the height of the pump or ECMO flow. The bypass conduit pressure and distance from the post-oxygenator port were measured to find the “safety point”, where the bypass pressure remained within the safety range. Both drainage and return limbs of the CRRT machine were connected to the safety point and the inlet and outlet pressures of the hemofilter were recorded while varying the ECMO and CRRT flow. The pre-pump pressure only remained within the safety range for heights >75 cm (ECMO flow = 4 L/min) or ECMO flow 
ISSN:1434-7229
1619-0904
DOI:10.1007/s10047-017-0952-y