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Peripherally inserted veno-venous ultrafiltration for rapid treatment of volume overloaded patients
Brian E Jaski1, Jae Ha, Bart G Denys
1San Diego Cardiac Center, Sharp Memorial Hospital, San Diego, California 92123, USA.
Background:
Veno-venous ultrafiltration may benefit patients with acute or chronic circulatory volume overload. Use of conventional systems, however, may be cumbersome, requiring physician placement of a double-lumen central venous catheter and use of a dedicated dialysis technician and apparatus.
Methods:
A simplified peripheral ultrafiltration system including a miniaturized disposable circuit was evaluated in patients with volume-overload states. Separate intravenous catheters (16-18 G) for withdrawal and return of blood (blood flow
Results:
The primary endpoint of greater than 1 L fluid removal in less than 8 hours was achieved in 23 of 25 treatments. On average, 2611 +/- 1002 mL (maximum 3,725 mL) of ultrafiltrate was removed per treatment (treatment period 6:43 +/- 1:47 hours:minutes). Patient weight decreased from 91.9 +/- 17.5 to 89.3 +/- 17.3 kg (P <.0001) after ultrafiltration. No major adverse events occurred.
Conclusions:
Rapid removal of extracellular and intravascular fluid volume excess can be safely achieved via peripherally inserted ultrafiltration without the need for central venous catheter placement.