Quantitative analysis of pulsatile flow contribution to ultrafiltration.

We evaluated the quantitative contribution of pulsatile flow to ultrafiltration (UF) in terms of fluid power, membrane stretch, and reduction of membrane layering. An in vitro comparison of the UF rate using pulsatile and roller pumps was performed with distilled water and bovine whole blood. The mean transmembrane pressure (TMPm) and UF rate were higher with the pulsatile pump for the same mean flow rate: 6.6 mm Hg and 21.1 mL/min higher on average for distilled water and 34.2 mm Hg and 31.4 mL/min higher on average for blood. The average UF rate was 8.4 mL/min higher with the pulsatile pump for the same TMPm with bovine blood. However, the relationship between the UF rate and the TMPm was independent of the flow configuration for distilled water. We showed that the higher UF rate in the pulsatile pump is mainly due to greater fluid power and reduction of membrane layering, while the membrane stretch was not an important factor.

[1]  J. López‐Herce,et al.  Continuous venovenous renal replacement therapy with a pulsatile tubular blood pump: analysis of efficacy parameters. , 2006, Artificial organs.

[2]  J. López‐Herce,et al.  Comparison of a Tubular Pulsatile Pump and a Volumetric Pump for Continuous Venovenous Renal Replacement Therapy in a Pediatric Animal Model , 2005, ASAIO journal.

[3]  M. Zamir The Physics of Coronary Blood Flow , 2005 .

[4]  T. Depner,et al.  Solute transport mechanisms in dialysis , 2004 .

[5]  L. Pedrini,et al.  On-line mixed hemodiafiltration with a feedback for ultrafiltration control: effect on middle-molecule removal. , 2003, Kidney international.

[6]  J. López‐Herce,et al.  Continuous venovenous renal replacement therapy using a pulsatile blood pump , 2002, Pediatric Nephrology.

[7]  E. Friedman,et al.  A New Method to Control Ultrafiltration in Conventional Continuous Renal Replacement Therapy , 2001, ASAIO journal.

[8]  R Schmidt,et al.  Prevention of haemodialysis-induced hypotension by biofeedback control of ultrafiltration and infusion. , 2001, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[9]  M. Miwa,et al.  Push/pull hemodiafiltration: technical aspects and clinical effectiveness. , 1999, Artificial organs.

[10]  A. Zydney,et al.  Protein‐Membrane Interactions During Hemodialysis Effects on Solute Transport , 1998, ASAIO journal.

[11]  S. E. Ottmers,et al.  Hemodialysis: Evidence of Enhanced Molecular Clearance and Ultrafiltration Volume by Using Pulsatile Flow , 1993, The International journal of artificial organs.

[12]  A. Leong,et al.  Spallation and migration of silicone from blood-pump tubing in patients on hemodialysis. , 1982, The New England journal of medicine.

[13]  E. Ritz,et al.  SILICONE CELL INCLUSIONS CAUSING MULTI-ORGAN FOREIGN BODY REACTION IN DIALYSED PATIENTS , 1981, The Lancet.