An acquired process instructed clinicians for one HD machine model (Fresenius 5008[R]) to include drainage of the HD extracorporeal circuit
, in conjunction with dialysate from the dialyser.
When citrate flows through the filter during RCA, citrate chelates the ionized calcium and decreases the concentration of the ionized calcium in the extracorporeal circuit
. Calcium bound to plasma proteins is partially dissociated with a decrease in the concentration of ionized calcium and filtered mainly in the form of a calcium-citrate complex by CVVH.
Aarts, "Mini extracorporeal circuit
for coronary artery bypass grafting: initial clinical and biochemical results: a comparison with conventional and off-pump coronary artery bypass grafts concerning global oxidative stress and alveolar function," Perfusion, vol.
Simulated circuit studies using neonatal circuits and pumps confirm the potential role of the extracorporeal circuit
in altering the PK of administered drugs (29,38).
Hypothermia: the extracorporeal circuit
cools the blood.
Due to the patient's deteriorating situation with respect to CVVH, I (WFVK) discussed with the physician the possibility of using heparin-free haemofiltration by using regional citrate and calcium infusion to prevent clotting of the extracorporeal circuit
. The doctor expressed his concerns about using a regional anticoagulant.
During HD, the clotting cascade is activated when blood components contact the extracorporeal circuit
CRRT uses an extracorporeal circuit
to ultrafilter plasma and remove water and wastes from a patient's blood.
Blood enters the extracorporeal circuit
through an access line, passes through the haemofilter, and returns to the patient\'s circulation via the return line.
CPFA is a relatively novel technique consisting in an extracorporeal circuit
in which three different filters work sequentially to remove a number of septic mediators, including TNF-a and several other mediators exerting either pro- or anti-inflammatory actions: at the same time continuous renal replacement therapy is provided (6).
The use of 5% dextrose instead of 0.9% saline for priming the extracorporeal circuit
in HD will reduce the IDWG, thus reducing the need for high UFR and preventing subsequent episodes of intravascular depletion during HD.