Effects of Novel Manufacturing Technology on Blood and Dialysate Flow Distribution in a New Low Flux “α Polysulfone” Hemodialyzer

2003 ◽  
Vol 26 (2) ◽  
pp. 105-112 ◽  
Author(s):  
F. Gastaldon ◽  
A. Brendolan ◽  
C. Crepaldi ◽  
P. Frisone ◽  
S. Zamboni ◽  
...  
Keyword(s):  
Blood Flow ◽  
Diffusion Process ◽  
Hollow Fiber ◽  
Flow Condition ◽  
Regional Blood Flow ◽  
Flow Distribution ◽  
Dialysate Flow ◽  
Blood Compartment

The main target for low flux hemodialyzers is an efficient low molecular weight solutes clearance. Such efficiency is largely dependent on the optimization of diffusion between blood and dialysis solution. The diffusion process can be impaired if there is a mismatch between blood and dialysate flow distribution in the dialyzer. Thus optimized flow distribution both in the blood and dialysate compartment becomes quintessential for the maximal efficiency of the diffusion process within the hemodialyzer. The present paper describes the distribution of the blood and dialysate flows in a new low flux polysulfone hollow fiber hemodialyzer characterized by a specific undulation of the fibers and a new cutting technology of the fibers for an improved micro-flow condition in the blood compartment headers. Twelve Diacap α Polysulfone LO PS 15 (1.5 sqm) (B.Braun Medizintechnologie, Melsungen Germany) were employed for the study. Six were analyzed in vitro and six were studied in vivo. Blood flow distribution was studied in vitro by dye injection in the blood compartment during experimental extracorporeal circulation utilizing human blood with hematocrit adjusted at 33%. Sequential images were obtained with a helical scanner in a fixed longitudinal section of the dialyzer 1 cm thick. Average and regional blood flow velocities were measured utilizing the reconstructed imaging sequence. The method allowed the calculation of single fiber blood flow (SF Qb) and the mass transfer zone (MTR) definition in digitally subtracted images. The patterns 20–10 and 40–30 were utilized. The same technology was used to evaluate flow distribution in the dialysate compartment after dye injection in the Hansen's connector. Regional dialysate flow was calculated in central and peripheral sample areas of 1 cm2. Six in vivo hemodialysis treatments on patients with end stage renal disease were performed at three different blood flow rates (250–350 and 450 ml/min) in order to measure urea, creatinine and phosphate clearance. Macroscopic and densitometrical analysis revealed that flow distribution was homogeneous in the blood compartment while in the dialysate compartment a slight difference between the peripheral and central regions in terms of flow velocity was observed. This however was not generating channeling phenomena. Urea creatinine and phosphate clearances were remarkably high and so were the Kt/V observed in all sessions, especially in relation to the studied blood flows. In conclusion, a significant blood to dialysate flow match with optimized countercurrent flow condition was observed in the studied hollow fiber hemodialyzers. Such optimization might be due both to the improved dialyzer design at the level of the blood header and to the specific fiber undulation that prevents dialysate channeling.

scholarly journals Anaesthesia and the Kidney

1983 ◽  
Vol 11 (4) ◽  
pp. 292-320 ◽  
Author(s):  
Michael J. Cousins ◽  
George Skowronski ◽  
John L. Plummer
Keyword(s):  
Blood Flow ◽  
Renal Blood Flow ◽  
Flow Distribution ◽  
Distal Tubule ◽  
Juxtaglomerular Apparatus ◽  
Anaesthetic Management ◽  
Anatomy And Physiology ◽  
Sympathetic Nervous Systems

Applied anatomy and physiology of the kidney are briefly reviewed. This includes an account of renal blood flow, glomerular filtration rate, juxtaglomerular apparatus, renal autoregulation and intra-renal blood flow distribution, tubular transport mechanisms, solute handling in proximal tubule, function of loop of Henle and distal tubule system. This section concludes with a summary of changes in tubule fluid along the length of the nephron. Acute effects of anaesthesia are reviewed in detail. Indirect effects include those on circulatory and sympathetic nervous systems, autoregulation, endocrine systems such as those involving antidiuretic hormone, adrenaline and noradrenaline, renin-angiotensin and aldosterone. Direct effects of anaesthesia on renal function have now been confirmed both in vitro and in vivo. Delayed direct nephrotoxicity of anaesthetics relates predominantly to methoxyflurane (MOF) and its metabolism to inorganic fluoride. Other factors are MOF dose, genetics, age, enzyme induction, obesity, other nephrotoxic drugs. Clinical implications are presented. Enflurane nephrotoxicity is rare but aetiologic factors are similar to the foregoing. Isoflurane and halothane are not nephrotoxic. A consideration of the influence of anaesthetic management on the incidence and severity of postoperative acute renal failure concludes the review.

Vasoactive agents and splanchnic oxygen uptake

1982 ◽  
Vol 243 (1) ◽  
pp. G1-G9 ◽  
Author(s):  
P. R. Kvietys ◽  
D. N. Granger
Keyword(s):  
Blood Flow ◽  
Oxygen Uptake ◽  
Oxidative Metabolism ◽  
Flow Distribution ◽  
Capillary Density ◽  
Exchange Capacity ◽  
Vasoactive Agents ◽  
Splanchnic Oxygen

Many vasoactive agents are known to alter oxygen uptake by splanchnic organs. Data from the literature indicate that, in general, vasodilators increase, whereas vasoconstrictors decrease oxygen uptake. We compare and contrast the effects of vasoactive agents on oxygen uptake observed in vivo, under constant-flow and free-flow conditions, to those observed in vitro. The discrepancies between the in vivo and in vitro data are discussed relative to the effects of vasoactive agents on blood flow, intraorgan blood flow distribution, the countercurrent exchange of oxygen, capillary exchange capacity, and oxidative metabolism. Changes in blood flow, oxidative metabolism, and capillary density appear to be the major mechanisms by which vasoactive agents alter splanchnic oxygen uptake in vivo. Experimental designs are proposed that may help minimize inconsistencies in the data in future studies.

Evaluation of a transit-time system for the chronic measurement of blood flow in conscious sheep

1995 ◽  
Vol 78 (2) ◽  
pp. 524-530 ◽  
Author(s):  
J. A. Bednarik ◽  
C. N. May
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Transit Time ◽  
Regional Blood Flow ◽  
Flow Probe ◽  
Time Flow ◽  
Bilateral Carotid ◽  
Conscious Sheep

The accuracy of transit-time ultrasonic flow probes for measurement of regional blood flow and cardiac output was evaluated after long-term implantation in sheep. Transit-time flow probes (3, 4, 6, and 20 mm) accurately measured flow in vitro. Recalibration in vivo demonstrated that this accuracy was maintained after 1–9 mo of implantation on the left circumflex coronary (3-mm probe), cranial mesenteric (6-mm probe), left renal (4-mm probe), and left external iliac (6-mm probe) arteries of sheep. The flow probes also showed good zero stability. However, a transit-time flow probe (20 mm) chronically implanted on the pulmonary trunk significantly underestimated cardiac output compared with thermodilution or timed collection of blood. Although this flow probe underestimated flow, the response was linear. Bilateral carotid occlusion caused mesenteric, renal, and iliac vasoconstrictions, confirming that innervation of these vascular beds was undamaged. For experimental purposes, regional blood flow was measured with transit-time flow probes and cardiac output was measured with electromagnetic flow probes calibrated against thermodilution. In summary, transit-time flow probes reliably and accurately measure regional blood flow over many months in adult sheep, but, to measure cardiac output in sheep, the probes must be calibrated in vivo against another reference technique.

scholarly journals Blood and Dialysate Flow Distributions in Hollow-Fiber Hemodialyzers Analyzed by Computerized Helical Scanning Technique

2002 ◽  
Vol 13 (suppl 1) ◽  
pp. S53-S61
Author(s):  
Claudio Ronco ◽  
Alessandra Brendolan ◽  
Carlo Crepaldi ◽  
Mariapia Rodighiero ◽  
Marco Scabardi
Keyword(s):  
Blood Flow ◽  
Flow Velocity ◽  
Hollow Fiber ◽  
Blood Flow Velocity ◽  
Flow Distribution ◽  
Single Fiber ◽  
Blood Flow Distribution ◽  
Type B ◽  
Dialysate Flow ◽  
Type C

ABSTRACT. The efficiency of a hemodialyzer is largely dependent on its ability to facilitate diffusion between blood and dialysis solution. The diffusion process can be impaired if there is a mismatch between blood and dialysate flow distribution in the dialyzer. This article describes the distribution of the blood and dialysate flows in hollow-fiber hemodialyzers analyzed with a computerized scanning technique. Blood flow distribution was studied in vitro by dye injection in the blood compartment during experimental extracorporeal circulation using human blood with hematocrit (Hct) adjusted at 25 and 40%. Sequential images were obtained with a helical scanner in a 1-cm-thick fixed longitudinal section of the dialyzer. Average and regional blood flow velocity and wall shear rates were measured by using the reconstructed imaging sequence. The method allowed the calculation of single-fiber blood flow and single-fiber wall shear rate (SF wSh) in different regions of the hemodialyzer. In 38 patients on chronic hemodialysis, creatinine and phosphate clearance displayed a significantly negative correlation with Hct (P < 0.05), but this correlation was not found for urea, although a trend toward reduction could be observed. The suggested explanation of this phenomenon is the significant reduction in effective plasma water flow across the hemodialyzer in presence of a progressive rise in Hct. The second explanation for this phenomenon may be found in the nonhomogeneous distribution of blood flow within the fibers observed at the sequential imaging. This, in fact, could also explain the negative trend observed for urea. At higher Hct levels, single-fiber blood flow velocity and SF wSh were significantly lower in the fibers situated at the periphery of the bundle. At the same time, SF wSh tended to decrease in peripheral fibers, showing a value near half of that observed in the central fibers of the bundle (165 versus 301 s−1). A similar technique was used to study the flow distribution in the dialysate compartment in three different types of hemodialyzers with characteristic dialysate compartment design: (A) standard configuration; (B) space yarns (spacing filaments preventing contact between fibers); and (C) Moiré structure (wave-shaped fibers to prevent contact between adjacent fibers). Clinical sessions of hemodialysis were also carried out to measure blood- and dialysate-side urea clearances in the different hemodialyzers. Macroscopic and densitometric analysis revealed that flow distribution was most homogeneous in the dialyzer with Moiré structure (type C) and least homogeneous in the standard dialyzer (type A). Space yarns (type B) gave an intermediate dialysate flow distribution. Urea clearance (P < 0.001) increased significantly with types B and C, compared with the standard dialyzer. Type C had the highest clearances, although they were not significantly greater than type B. In conclusion, a significant blood-to-dialysate flow mismatch may occur in hollow-fiber hemodialyzers due to either uneven blood flow distribution or a dialysate channeling phenomenon external to the fiber bundle. Improvement in dialyzer design may overcome these problems, at least in part.

Technical and clinical evaluation of a new polyamide hollow fiber hemofilter for CAVH

1988 ◽  
Vol 11 (1) ◽  
pp. 33-38 ◽  
Author(s):  
C. Ronco ◽  
A. Brendolan ◽  
L. Bragantini ◽  
A. Fabris ◽  
M. Feriani ◽  
...  
Keyword(s):  
Blood Flow ◽  
Hollow Fiber ◽  
Ultrafiltration Rate ◽  
Blood Flows ◽  
Continuous Arteriovenous Hemofiltration ◽  
Severe Hypotension ◽  
Alternative Techniques ◽  
New Generation

We carried out an in-vivo and in-vitro evaluation of a new polyamide hollow fiber hemofilter especially designed to operate under conditions of low pressure and low blood flow, such as in continuous arteriovenous hemofiltration (CAVH). The results obtained suggest that this filter is a prototype of a new generation of hemofilters especially designed for CAVH. Its low resistance permits its use even in patients with severe hypotension. The high blood flows achieved at a given pressure reduce the risk of clotting and increase the ultrafiltration rate. When an average ultrafiltration of 20-25 ml/min is achieved in 24 hours CAVH becomes very efficient, and alternative techniques to increase its efficiency are no longer required.

Alterations in distribution of cardiac output in experimental diabetes in rats

1989 ◽  
Vol 257 (2) ◽  
pp. H571-H580 ◽  
Author(s):  
M. A. Hill ◽  
R. G. Larkins
Keyword(s):  
Skeletal Muscle ◽  
Blood Flow ◽  
Cardiac Output ◽  
Cardiac Index ◽  
Regional Blood Flow ◽  
Flow Distribution ◽  
Body Weight Loss ◽  
Abdominal Organs ◽  
Thoracic And Abdominal

Alterations in blood flow distribution in streptozotocin-induced diabetes in the rat were examined. Blood flow between tissues was estimated by the distribution of radiolabeled microspheres, and a second series of experiments examined skeletal muscle microcirculation by in vivo microscopy. Studies were performed in anesthetized rats 1-8 wk after induction of diabetes. Cardiac index was transiently increased in diabetic animals (29.6 +/- 1.0 ml.min-1.100 g-1) in comparison with control animals (23.0 +/- 1.4 ml.min-1.100 g-1) at 2-wk duration. Cardiac index was similar in both groups of animals at all other time points studied. The increased cardiac index coincided with transiently increased blood flow to diaphragm and abdominal wall and a significant vasodilatation of small cremaster muscle arterioles. Blood flow to skin and some skeletal muscles was thereafter significantly decreased in the diabetic animals. Blood flow (ml.min-1.100 g-1) to the brain and main thoracic and abdominal organs was similar in nonfasting control and diabetic animals throughout the period of study. As a result of hyperplasia, blood flow to the small intestine (%cardiac output) was increased in the diabetic animals (at 4 wk of diabetes, 34.5 +/- 2.1 vs. 17.5 +/- 0.8%, P less than 0.001). Despite reduction in blood flow to the intestine, by dietary restriction, flow to skin and skeletal muscle remained significantly decreased. Insulin treatment, at a dose aimed at preventing body weight loss but maintaining hyperglycemia, led to renal hyperperfusion in comparison with untreated diabetic and control animals. The alterations in regional blood flow appear progressive in nature and are not simply related to each other but may reflect tissue adaptation to the metabolic disorder.

Effect of caffeine on theophyliine on cerebral blood flow response to brain activation: In vitro and in vivo studies

2005 ◽  
Vol 25 (1_suppl) ◽  
pp. S198-S198
Author(s):  
Joseph R Meno ◽  
Thien-son K Nguyen ◽  
Elise M Jensen ◽  
G Alexander West ◽  
Leonid Groysman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Activation ◽  
In Vivo Studies ◽  
Blood Flow Response ◽  
Flow Response

Regional blood flow measurement in vivo for a definable geometry

1964 ◽  
Vol 206 (5) ◽  
pp. 962-966 ◽  
Author(s):  
Marvin B. Bacaner ◽  
James S. Beck
Keyword(s):  
Blood Flow ◽  
Flow Measurement ◽  
Necessary Conditions ◽  
Regional Blood Flow ◽  
The Body ◽  
Continuous Measure ◽  
Radioisotope Method ◽  
Arterial Concentration ◽  
Regional Concentration

A radioisotope method for measuring regional blood flow in the intestine of the dog in vivo has been favorably compared with measurement by timed collection of total venous outflow. The necessary conditions are a continuous measure of arterial concentration and cumulative regional concentration of radioisotope, an experimentally definable region, and temporary complete retention of tracer. The derivation of the relations used suggests additional applications of the method to other regions of the body.

Abstract WP498: Impaired Pericyte Constriction and Cerebral Blood Flow Autoregulationin Diabetes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yedan Liu ◽  
Shaoxun Wang ◽  
Ya Guo ◽  
Huawei Zhang ◽  
Richard Roman ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Ex Vivo ◽  
Mitochondrial Dynamics ◽  
Vascular Cognitive Impairment ◽  
Treated Group ◽  
Diabetic Rats ◽  
Cerebrovascular Function

Diabetes is the primary pathological factor attributed to Alzheimer’s disease and vascular cognitive impairment. Previous studies demonstrated that hyperglycemia promoted oxidative stress in the cerebral vasculature. Cerebrovascular pericytes contribute to maintaining blood-brain barrier (BBB) integrity and regulating cerebral blood flow (CBF). However, whether hyperglycemia diminishes the contractile capability of pericytes, impairs CBF autoregulation and increases BBB permeability are unclear. In the present study, we examined the role of pericytes in cerebrovascular function and cognition in diabetes using cell culture in vitro , isolated penetrating arterioles ex vivo and CBF autoregulation in vivo . Reactive oxygen species were elevated in high glucose (HG, 30 mM) treated vs. normal glucose (NG, 5.5 mM) treated pericytes. Further, mitochondrial superoxide production was increased in HG-treated vs. NG-treated group (13.24 ± 1.01 arbitrary unit (a.u.)/30min vs. 6.98 ± 0.36 a.u./30min). Mitochondrial respiration decreased in HG-treated vs. NG-treated pericytes (3718 ± 185.9 pmol/min/mg, n=10 vs. 4742 ± 284.5 pmol/min/mg, n=10) as measured by a Seahorse XFe24 analyzer. HG-treated pericytes displayed fragmented mitochondria in association with increased fission protein (DRP1) and decreased fusion protein (OPA1) expression. HG-treated pericytes displayed lower contractile capability than NG-treated cells (20.23 ± 7.15% vs. 29.46 ± 9.41%). The myogenic response was impaired in penetrating arterioles isolated from diabetic rats in comparison with non-diabetic rats. Autoregulation of CBF measured by a laser Doppler flowmeter was impaired in diabetic rats compared with non-diabetic rats. Diabetic rats exhibited greater BBB leakage than control rats. The cognitive function was examined using an eight-arm water maze. Diabetic rats took longer time to escape than the non-diabetic rats indicating learning and memory deficits. In conclusion, hyperglycemia induces pericyte dysfunction by altering mitochondrial dynamics and diminishing contractile capability, which promotes BBB leakage, decreases CBF autoregulation and contributes to diabetes-related dementia.

scholarly journals Effects of aging and exercise training on spinotrapezius muscle microvascular Po2 dynamics and vasomotor control

2011 ◽  
Vol 110 (3) ◽  
pp. 695-704 ◽  
Author(s):  
Danielle J. McCullough ◽  
Robert T. Davis ◽  
James M. Dominguez ◽  
John N. Stabley ◽  
Christian S. Bruells ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Blood Flow ◽  
Exercise Training ◽  
Sodium Nitroprusside ◽  
Vascular Function ◽  
Treadmill Running ◽  
Aged Rats ◽  
Phosphorescence Quenching

With advancing age, there is a reduction in exercise tolerance, resulting, in part, from a perturbed ability to match O2 delivery to uptake within skeletal muscle. In the spinotrapezius muscle (which is not recruited during incline treadmill running) of aged rats, we tested the hypotheses that exercise training will 1) improve the matching of O2 delivery to O2 uptake, evidenced through improved microvascular Po2 (PmO2), at rest and throughout the contractions transient; and 2) enhance endothelium-dependent vasodilation in first-order arterioles. Young (Y, ∼6 mo) and aged (O, >24 mo) Fischer 344 rats were assigned to control sedentary (YSED; n = 16, and OSED; n = 15) or exercise-trained (YET; n = 14, and OET; n = 13) groups. Spinotrapezius blood flow (via radiolabeled microspheres) was measured at rest and during exercise. Phosphorescence quenching was used to quantify PmO2 in vivo at rest and across the rest-to-twitch contraction (1 Hz, 5 min) transition in the spinotrapezius muscle. In a follow-up study, vasomotor responses to endothelium-dependent (acetylcholine) and -independent (sodium nitroprusside) stimuli were investigated in vitro. Blood flow to the spinotrapezius did not increase above resting values during exercise in either young or aged groups. Exercise training increased the precontraction baseline PmO2 (OET 37.5 ± 3.9 vs. OSED 24.7 ± 3.6 Torr, P < 0.05); the end-contracting PmO2 and the time-delay before PmO2 fell in the aged group but did not affect these values in the young. Exercise training improved maximal vasodilation in aged rats to acetylcholine (OET 62 ± 16 vs. OSED 27 ± 16%) and to sodium nitroprusside in both young and aged rats. Endurance training of aged rats enhances the PmO2 in a nonrecruited skeletal muscle and is associated with improved vascular smooth muscle function. These data support the notion that improvements in vascular function with exercise training are not isolated to the recruited muscle.

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