Continuous venovenous renal replacement therapy using a pulsatile blood pump.

Abstract

The objective of this study was to evaluate the efficacy of a pulsatile pump for continuous renal replacement therapy in a pediatric-size animal model. A vacuum-driven, tubular, blood-pumping device was used in 13 pigs weighing 10.4+/-1.5 kg, connected to a neonatal hemofiltration circuit with an FH22 filter and a flow sensor. Three different flow rates [30 ml/min (8 cases), 15 ml/min (3 cases), and 5 ml/min (2 cases] were used over 2-h periods. Aspiration pressure, frequency of pulsation, blood flow rate, ultrafiltrate volume, pre- and post-filter pressures, heart rate, arterial blood pressure, temperature, pH, sodium, potassium, chloride, urea, creatinine, glucose, and hematocrit were measured at 30-min intervals. The mean ultrafiltrate flow was 0.54+/-0.33 ml/kg per min. The aspiration pressure and pulsation frequency needed to maintain blood flow remained stable throughout the experiment. There were no complications secondary to the use of this technique and no significant changes in heart rate, blood pressure, or analytical determinations. In conclusion, in this animal model, the pulsatile pump has been shown to be an effective method for continuous venovenous renal replacement therapy.