Extracorporeal chloride removal to treat acidemia: in vitro evaluation of three techniques

التفاصيل البيبلوغرافية
العنوان: Extracorporeal chloride removal to treat acidemia: in vitro evaluation of three techniques
المؤلفون: Rezoagli, E, De Falco, S, Fumagalli, J, Busana, M, Rigoli, A, Protti, I, Tomaselli, A, Battistin, M, Castagna, L, Deab, SAEAES, Giani, M, Pesenti, A, Zanella, A.
المساهمون: European Society of Intensive Care Medicine, Rezoagli, E, De Falco, S, Fumagalli, J, Busana, M, Rigoli, A, Protti, I, Tomaselli, A, Battistin, M, Castagna, L, Deab, S, Giani, M, Pesenti, A, Zanella, A
بيانات النشر: Springer Open
سنة النشر: 2018
المجموعة: Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive)
مصطلحات موضوعية: acidemia, chloride removal, extracorporeal technique, anion Exchange Resin, hypochlorous reinfusate, electrodialysis, MED/41 - ANESTESIOLOGIA
الوصف: INTRODUCTION. Acidemia is a frequent disorder in critically ill patients. Blood chloride removal may increase blood pH. Extracorporeal chloride removal may be achieved through: 1. Electrodialysis (ED), a technique that selectively move anions from one solution to another through ion-exchange membranes using electricity (1); 2. ultrafiltration (UF) and postdilution with hypochlorous reinfusate; 3. UF through anion Exchange Resin (a-ER) which replaces chloride with bicarbonate ions. OBJECTIVES. To evaluate, in-vitro, the chloride removal efficacy of these three different strategies. METHODS. A standard reinfusate solution (CB 32, Novaselect) (technique 1) and a bicarbonate-based solution (Multibic®) (technique 2 and 3) were pumped through an hemodiafilter at 150 mL/min. The following strategies have been studied: 1. “ED group”: the UF entered an ED chamber where chloride ions were replaced by hydroxide ions (OH-). Subsequently OHions were combined with CO2 to form bicarbonate within a membrane lung and the solution was reinfused in the main stream; 2. “Hypochlorous group”: the UF was discarded and the same volume was reinfused in postdilution as sodium bicarbonate 140 mEq/L; 3. “a-ER group”: the UF was pumped through an a-ER and then reinfused in postdilution. In Hypochlorous and aER groups, UF flows of 11.4, 22.7 and 34.1 mL/ min were tested. In the ED group, 3 different UF flows 15, 30 and 45 mL/min were tested, with a fixed amperage (4 Amp) and recirculating flow was set to equalize the UF tested, to achieve a theoretical removal of 1.25, 2.5, 3.75 mEq/min of chloride, respectively. Before the hemodiafilter and downstream after reinfusion the solution was sampled for UF gas analysis and then wasted. The change in chloride among the two sampling sites was calculated to quantify chloride removal. The experiment was repeated three times. Data are reported as mean±SD. RESULTS. 1. In the “ED group”, chloride removal was 0.47±0.06, 0.96±0.11 and 1.22±0.17 mEq/min at 15, 30 and 45 mL/min of UF flow, respectively. 2. ...
نوع الوثيقة: conference object
وصف الملف: ELETTRONICO
اللغة: English
العلاقة: info:eu-repo/semantics/altIdentifier/pmid/30341496; info:eu-repo/semantics/altIdentifier/wos/WOS:000454848500001; ispartofbook:ESICM LIVES 2018; European Society of Intensive Care Medicine LIVES 2018; volume:6; issue:Suppl 2; journal:INTENSIVE CARE MEDICINE EXPERIMENTAL; alleditors:European Society of Intensive Care Medicine; http://hdl.handle.net/10281/287271Test; https://icm-experimental.springeropen.com/articles/10.1186/s40635-018-0201-6Test
DOI: 10.1186/s40635-018-0201-6
الإتاحة: https://doi.org/10.1186/s40635-018-0201-6Test
http://hdl.handle.net/10281/287271Test
حقوق: info:eu-repo/semantics/openAccess
رقم الانضمام: edsbas.937732B3
قاعدة البيانات: BASE