Development and Validation of a Simplified Renal Replacement Therapy Suitable for Prolonged Field Care in a Porcine (Sus scrofa) Model of Acute Kidney Injury
Technical Report,23 Mar 2017,15 Mar 2018
DAVID GRANT USAF MEDICAL CENTER TRAVIS AFB CA TRAVIS AFB United States
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Objectives To validate a RRT system compatible with prolonged field care PFC. We hypothesized that our improvised RRT IRRT system would have similar performance to conventional RRT CRRT. Methods Twelve swine were anesthetized. A dialysis catheter was introduced. Bilateral nephrectomies were performed. The aorta was occluded in Zone 3 for 2 hours. Animals were randomized to CRRT or IRRT. In the IRRT group, the arterial line of the dialysis catheter was connected to a Belmont rapid infuser which was then connected to a Gambro dialysis cartridge, and subsequently to the venous line of the dialysis catheter. Replacement fluids were made with stock solutions. At the end of the 2-hour occlusion, animals received 4 hours of RRT. Animals were treated with isotonic crystalloids and norepinephrine to maintain their mean arterial pressure. Results There was no difference in serum creatinine, electrolytes, dialysate or ultra filtrate volumes between the groups. There was no difference between the commercial and the custom-made replacement fluids. There was no difference in serum lactate, isotonic crystalloids, or norepinephrine required for resuscitation. Conclusion The IRRT system achieved similar performance as the CRRT. The IRRT system may prove helpful for the treatment of severe AKI in PFC.
- Medicine and Medical Research