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

Recruiting

• Conditions: Respiratory Failure With Hypercapnia
• Interventions: Other: continuous renal replacement therapy

• Registration Number: NCT05989971
• Lead Sponsor: Southeast University, China

Brief Summary

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.

Detailed 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.

Study Timeline

• Study Start: 2023-04-24
• Study First Submitted: 2023-07-31
• Status Verified: 2023-08
• Study First Submitted QC: 2023-08-05
• Last Update Submitted: 2023-08-05
• Study First Posted: 2023-08-14
• Last Update Posted: 2023-08-14
• Primary Completion: 2023-12
• Study Completion: 2023-12

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 10

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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Extracorporeal carbon dioxide removal combined with continuous renal replacement therapy	continuous renal replacement therapy	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.

Primary Outcome Measures

Name	Time	Method
extracorporeal CO2 removal rate	after 30min of continuous renal replacement therapy	extracorporeal CO2 removal rate was calculated as the difference of total CO2 content before membrane lung and after hemofilter, and normalized to an inlet PCO2 of 45 mmHg

Trial Locations

Locations (1)

Ling Liu; 🇨🇳 Nanjing, Jiangsu, China