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Albumin priming does not prolong hemofilter life
J H Reeves1, P F Seal, A L Voss
1Department of Intensive Care, St Vincent's Hospital, Fitzroy, Victoria, Australia.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|May 1, 1997
Summary
Prepriming hemofilters with albumin instead of saline did not improve filter survival time in critically ill patients. This study found no significant difference in hemofilter life between the two priming solutions.
Area of Science:
- Nephrology
- Critical Care Medicine
- Biomaterials Science
Background:
- Continuous venovenous hemodiafiltration (CVVHDF) is crucial for managing acute kidney injury in intensive care units.
- Hemofilter lifespan is a critical factor influencing treatment efficiency and cost.
- Optimizing hemofilter performance through effective priming strategies is an ongoing area of research.
Purpose of the Study:
- To investigate whether prepriming hemofilters with heparinized human albumin (NSA) enhances filter survival time compared to heparinized saline (NS).
- To evaluate the impact of albumin priming on hemofilter function and patient anticoagulation parameters.
Main Methods:
- A randomized controlled trial was conducted in an intensive care unit.
- Patients requiring CVVHDF without coagulopathy were randomized to hemofilter priming with either NS or NSA.
- Filter survival time was analyzed using survival analysis, with elective discontinuations censored.
Main Results:
- No significant difference was observed in median hemofilter survival time between the NS (37.8 hours) and NSA (45.4 hours) groups (p=0.998).
- Anticoagulation parameters (activated partial thromboplastin time) and platelet counts remained similar between the two groups.
- The study possessed over 90% power to detect a 50% improvement in filter life, indicating robust negative findings.
Conclusions:
- Prepriming hemofilters with heparinized human albumin does not offer a significant advantage in extending filter survival time compared to heparinized saline.
- Albumin priming is not recommended as a strategy to improve hemofilter longevity in CVVHDF.
- Further research may explore alternative priming agents or strategies to enhance hemofilter performance.