Blood Purification, Dual-cannula, Vena Cava Disconnection
Conditions
Brief summary
Acute kidney failure (AKI) is one of the most important causes of morbidity and mortality for critical ill patients. The use of blood purification treatment such as renal replacement therapy (CRRT) and plasma exchange has gradually developed into an effective treatment. However, the efficiency of blood purification may be affected by the recirculation of dual-lumen venous catheter for some special patients including patients with vena cava reflux disorder from massive occupations or ascites. For extreme cases like patients with vena cava disconnection or severe obstruction, the traditional blood purification treatment cannot work effectively. Thus, we used the dual-cannula in jugular-femoral venous blood purification therapy in the following two patients and found that it can improve the perfusion of systemic circulation and the prognosis of patients
Interventions
We add a dialysis catheter to the patient, i.e., replace single-cannula in femoral venous with dual-cannula in jugular-femoral venous
Sponsors
Study design
Eligibility
Inclusion criteria
* 1\. patients requiring haemodilution therapy for various reasons (acute renal failure, acute liver failure, etc.) * 2\. presence of superior vena cava and/or inferior vena cava reflux disorders * 3\. age greater than 18 years
Exclusion criteria
* 1\. Inability to establish suitable vascular access * 2\. Pregnant women * 3\. Not agreeing to active life support treatment * 4\. Severe active bleeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| vasoactive drugs | 144 hours after dual-cannula in jugular-femoral venous | doses of vasoactive drugs |
| ICU mortality | 28-day ICU mortality | Measurement of ICU mortality |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cytokine | 24hous after dual-cannula in jugular-femoral venous | Checking cytokine levels by laboratory |