The Effect of Continuous Renal Replacement Therapy on the Efficiency of Extracorporeal CO2 Removal

Southeast University, China

Status: Completed

Conditions: Respiratory Failure With Hypercapnia

Treatments: Other: continuous renal replacement therapy

Study type: Observational

Funder types: Other

Identifiers

NCT05989971

20230731

Details and patient eligibility

About

In the design of extracorporeal carbon dioxide removal (ECCO2R) combined with continuous renal replacement therapy (CRRT) equipment, in model of continuous veno-venous hemofiltration (CVVH) , the HCO3- concentration in the pre membrane lung blood is diluted by the replacement solution, and a decrease in HCO3- leads to a decrease in PCO2. On the other hand, in continuous veno-venous hemodialysis (CVVHD), HCO3- in post membrane blood will exchange interaction. The exchange results of HCO3- determine the impact of CVVHD on the CO2 removal efficiency of the ECCO2R combined CRRT system. This study aims to investigate the effects of CVVH and CVVHD on in vitro CO2 clearance efficiency.

Full description

In the design of extracorporeal carbon dioxide removal (ECCO2R) combined with continuous renal replacement therapy (CRRT) equipment, the pre dilution replacement solution for continuous veno-venous hemofiltration (CVVH) enters the extracorporeal bloodstream upstream of the membrane lung, so the HCO3- concentration in the pre membrane lung blood is diluted by the replacement solution. HCO3- and dissolved CO2 are in a dynamic and rapid equilibrium state, and a decrease in HCO3- leads to a decrease in PCO2. On the other hand, in continuous veno-venous hemodialysis (CVVHD), the blood after the membrane needs to undergo material exchange with the dialysate through a filter. The dialysate is usually HCO3- with normal plasma concentration, so HCO3- in post membrane blood will exchange interaction. The exchange results of HCO3- determine the impact of CVVHD on the CO2 removal efficiency of the ECCO2R combined CRRT system. This study aims to investigate the effects of CVVH and CVVHD on in vitro CO2 clearance efficiency.

Enrollment: 10 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Using Extracorporeal carbon dioxide removal combined with continuous renal replacement therapy
• 18 years ≤ age ≤ 85 years;

Exclusion criteria

• Severe hemodynamic instability (increased dosage of vasoactive drugs or MAP ≤ 65mmHg within two hours);
• Severe electrolyte deficiency (including severe hyponatremia (blood sodium<130mmol/L) and hypokalemia (blood potassium<3.0mmol/L));
• Participate in other intervention studies within 30 days;
• Do not consent this research

Trial design

10 participants in 1 patient group

Extracorporeal carbon dioxide removal combined with continuous renal replacement therapy

Description:

extracorporeal carbon dioxide removal combined with continuous veno-venous hemofiltration or continuous veno-venous hemodialysis.CVVH and CVVHD set-up: predilution 30 ml/kg/h, dialysate dose 30 ml/kg/h, ultrafiltration rate was equal to the total rate of substitution fluid infusion.

Treatment:

Other: continuous renal replacement therapy