YaBeSH Engineering and Technology Library

    • Journals
    • PaperQuest
    • YSE Standards
    • YaBeSH
    • Login
    View Item 
    •   YE&T Library
    • ASME
    • Journal of Medical Devices
    • View Item
    •   YE&T Library
    • ASME
    • Journal of Medical Devices
    • View Item
    • All Fields
    • Source Title
    • Year
    • Publisher
    • Title
    • Subject
    • Author
    • DOI
    • ISBN
    Advanced Search
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Archive

    Assessment of Current Continuous Hemofiltration Systems and Development of a Novel Accurate Fluid Management System for Use in Extracorporeal Membrane Oxygenation

    Source: Journal of Medical Devices:;2008:;volume( 002 ):;issue: 003::page 35002
    Author:
    Philippe Sucosky
    ,
    Matthew L. Paden
    ,
    Ajit P. Yoganathan
    ,
    James D. Fortenberry
    ,
    Lakshmi P. Dasi
    DOI: 10.1115/1.2952818
    Publisher: The American Society of Mechanical Engineers (ASME)
    Abstract: Extracorporeal membrane oxygenation (ECMO) with a renal replacement therapy such as continuous venovenous hemofiltration (CVVH) provides life-saving temporary heart and lung, and renal support in pediatric and neonatal intensive care units. However, studies have shown that this approach may be hampered due to the potentially inaccurate fluid delivery∕drainage of current intravenous (IV) fluid pumps, creating potential for excessive fluid removal and undesired degrees of dehydration. We present a simple and novel accurate fluid management system capable of working against the high volume flow and pressures typically seen in patients on ECMO. The accuracy of the in-line system implemented at Children’s Healthcare of Atlanta at Egleston was assessed experimentally. The data assisted in the development of a novel automated and accurate fluid management system that functions based on a conservation of volume approach to limit the inaccuracies observed in typical clinical implementations of CVVH. IV pump accuracy measurements demonstrated a standard error in net ultrafiltrate volume removed from the patient of up to 848.5±156ml over a period of 24h, supporting previous observations of patient’s dehydration during the course of a combined ECMO-CVVH treatment and justifying the need for a new fluid management system. The innovative design of the new device is expected to achieve either a perfect or controlled negative fluid balance between the ultrafiltrate and replacement fluid flow rates. Perfect fluid balance is achieved by imposing an identical displacement on two pistons, one delivering replacement fluid to the circuit and the other draining ultrafiltrate from the hemofilter. Fluid removal is managed via a second syringe-pump system that reduces the net replacement fluid flow rate with respect to the ultrafiltration flow rate. The novel fluid management system described in this paper is expected to provide an effective method to control precisely fluid flow rates in patients on ECMO. Therefore, this device could potentially improve the efficacy of ECMO therapy and constitute a safe and effective way of reducing fluid overload in patients with cardiorespiratory failure.
    keyword(s): Fluids , Pumps AND Membranes ,
    • Download: (786.7Kb)
    • Show Full MetaData Hide Full MetaData
    • Get RIS
    • Item Order
    • Go To Publisher
    • Price: 5000 Rial
    • Statistics

      Assessment of Current Continuous Hemofiltration Systems and Development of a Novel Accurate Fluid Management System for Use in Extracorporeal Membrane Oxygenation

    URI
    http://yetl.yabesh.ir/yetl1/handle/yetl/138997
    Collections
    • Journal of Medical Devices

    Show full item record

    contributor authorPhilippe Sucosky
    contributor authorMatthew L. Paden
    contributor authorAjit P. Yoganathan
    contributor authorJames D. Fortenberry
    contributor authorLakshmi P. Dasi
    date accessioned2017-05-09T00:29:53Z
    date available2017-05-09T00:29:53Z
    date copyrightSeptember, 2008
    date issued2008
    identifier issn1932-6181
    identifier otherJMDOA4-27994#035002_1.pdf
    identifier urihttp://yetl.yabesh.ir/yetl/handle/yetl/138997
    description abstractExtracorporeal membrane oxygenation (ECMO) with a renal replacement therapy such as continuous venovenous hemofiltration (CVVH) provides life-saving temporary heart and lung, and renal support in pediatric and neonatal intensive care units. However, studies have shown that this approach may be hampered due to the potentially inaccurate fluid delivery∕drainage of current intravenous (IV) fluid pumps, creating potential for excessive fluid removal and undesired degrees of dehydration. We present a simple and novel accurate fluid management system capable of working against the high volume flow and pressures typically seen in patients on ECMO. The accuracy of the in-line system implemented at Children’s Healthcare of Atlanta at Egleston was assessed experimentally. The data assisted in the development of a novel automated and accurate fluid management system that functions based on a conservation of volume approach to limit the inaccuracies observed in typical clinical implementations of CVVH. IV pump accuracy measurements demonstrated a standard error in net ultrafiltrate volume removed from the patient of up to 848.5±156ml over a period of 24h, supporting previous observations of patient’s dehydration during the course of a combined ECMO-CVVH treatment and justifying the need for a new fluid management system. The innovative design of the new device is expected to achieve either a perfect or controlled negative fluid balance between the ultrafiltrate and replacement fluid flow rates. Perfect fluid balance is achieved by imposing an identical displacement on two pistons, one delivering replacement fluid to the circuit and the other draining ultrafiltrate from the hemofilter. Fluid removal is managed via a second syringe-pump system that reduces the net replacement fluid flow rate with respect to the ultrafiltration flow rate. The novel fluid management system described in this paper is expected to provide an effective method to control precisely fluid flow rates in patients on ECMO. Therefore, this device could potentially improve the efficacy of ECMO therapy and constitute a safe and effective way of reducing fluid overload in patients with cardiorespiratory failure.
    publisherThe American Society of Mechanical Engineers (ASME)
    titleAssessment of Current Continuous Hemofiltration Systems and Development of a Novel Accurate Fluid Management System for Use in Extracorporeal Membrane Oxygenation
    typeJournal Paper
    journal volume2
    journal issue3
    journal titleJournal of Medical Devices
    identifier doi10.1115/1.2952818
    journal fristpage35002
    identifier eissn1932-619X
    keywordsFluids
    keywordsPumps AND Membranes
    treeJournal of Medical Devices:;2008:;volume( 002 ):;issue: 003
    contenttypeFulltext
    DSpace software copyright © 2002-2015  DuraSpace
    نرم افزار کتابخانه دیجیتال "دی اسپیس" فارسی شده توسط یابش برای کتابخانه های ایرانی | تماس با یابش
    yabeshDSpacePersian
     
    DSpace software copyright © 2002-2015  DuraSpace
    نرم افزار کتابخانه دیجیتال "دی اسپیس" فارسی شده توسط یابش برای کتابخانه های ایرانی | تماس با یابش
    yabeshDSpacePersian