透析器可重用性的决定因素。

ASAIO transactions Pub Date : 1991-07-01
S G Sievers, J L Stack, W F Piering, E P Cohen
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引用次数: 0

摘要

作者观察到在血透患者中每个透析器的使用数量有很大的差异。在54例重复使用透析器的患者中,肝素剂量(U/kg/min)与重复使用透析器直接相关,白细胞计数与重复使用透析器负相关。糖尿病患者(n = 13)的平均重复使用为5.1 +/- 2.9 (SD),非糖尿病患者(n = 41)的平均重复使用为7.8 +/- 3.8 (SD);P = 0.007)。在糖尿病患者中,77%实现了6次或更少的重复使用,59%的非糖尿病患者实现了6次或更多的重复使用(卡方= 4.96;P < 0.05)。在非糖尿病患者中,肝素剂量是最显著的决定因素,而在糖尿病患者中,主要的决定因素是白细胞计数。红细胞压积水平、血小板计数、促红细胞生成素使用或膜类型(聚砜/醋酸纤维素)与可重复使用性无关。结论:糖尿病患者、肝素剂量较低(U/kg/min)患者和白细胞计数较高的患者透析器的可重复使用性较低。透析器可重用性的决定因素值得进一步研究。
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Determinants of dialyzer reuseability.

The authors observed a wide variability in the number of uses per dialyzer in their hemodialysis patients. In 54 patients who reused their dialyzers, heparin dose (U/kg/min) related directly and white blood cell count related inversely to reuseability. Average reuse was 5.1 +/- 2.9 (SD) in diabetics (n = 13) and 7.8 +/- 3.8 (SD) in non-diabetics (n = 41; p = 0.007). Of the diabetics, 77% achieved six or less reuses, and 59% of non-diabetics achieved six or more reuses (chi-square = 4.96; p less than 0.05). In non-diabetics, heparin dose was the most significant determinant of reuse, and in diabetics the major determinant was white blood cell count. Hematocrit levels, platelet count, erythropoietin use, or type of membrane (polysulfone/cellulose acetate) did not correlate with reuseability. It was concluded that reuseability of dialyzers is less in diabetic patients, patients on lower heparin doses (U/kg/min), and patients with higher white blood cell counts. Determinants of dialyzer reuseability warrant further study.

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Mechanism of dialysis-induced hypotension. Platelet preservation during cardiopulmonary bypass with iloprost and Duraflo-II heparin-coated surfaces. Peritoneal fluid kinetics during CAPD measured with intraperitoneal dextran 70. Influence of centrifugal blood pumps on the elasticity of erythrocytes. Reuse of "highly permeable" dialyzers with peroxyacetic acid as sole cleansing and disinfecting agent.
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