Tomohiro Matsui1, Takafumi Nakagawa2, Hitomi Kikuchi3, Hiroyuki Horio4, Kazuhiko Hashimura2. 1. Department of Clinical Engineering, Hanwa Memorial Hospital, 7-11-11 Karita, Sumiyoshi-ku,Osaka 558-0011, Japan. 2. Cardiovascular Center, Hanwa Memorial Hospital, 7-11-11 Karita, Sumiyoshi-ku,Osaka 558-0011, Japan. 3. Department of Medical Engineering, Aino University, 4-5-4 Higashiohda, Ibaraki,Osaka 567-0012, Japan. 4. Graduate School of Applied Informatics, University of Hyogo, 7-1-28 Minatojima-Minamimachi, Chuo-ku,Kobe, Hyogo650-0047, Japan.
Abstract
INTRODUCTION: Hemodialysis (HD) with low blood flow rate, continuous renal replacement therapy (CRRT), and peritoneal dialysis are recommended for patients with stroke complications to prevent intracranial hypertension because of the low diffusion capacity of the brain barrier. However, detailed guidelines are not currently available; thus, there is an urgent need to establish such guidelines. MATERIAL AND METHODS: We developed a novel protocol for performing CRRT with the AN69ST membrane, which has excellent adsorption capacity for various cytokines. The objective of this study was to compare the effect of the novel protocol with that of the current standard protocol, i.e. hemodialysis with low blood flow rate. To compare the effect of hemodialysis with low blood flow (HD group, n=27) and CRRT with AN69ST membrane (CRRT group, n=8), we measured the following consciousness and blood inflammatory parameters in patients with stroke complications at baseline and after 1 week of treatment: Glasgow Coma Scale (GCS) score, C-reactive protein (CRP) levels, and white blood cell (WBC) and platelet count. RESULTS: After 1 week, the total GCS score did not improve in the HD group, but improved significantly in the CRRT group (HD group: 13.1±3.0 to 13.3±3.1, p=0.5508, CRRT group: 8.9±3.9 to 11.5±3.9, p=0.0313). Improvement in the CRRT group was significantly higher than in the HD group (p=0.0039). CRP levels did not change significantly in either the HD (3.8±5.5 to 5.3±4.3 n.s.) or CRRT groups (7.7±10.0 to 3.7±3.2 n.s.); however, they tended to increase in the HD group and decrease in the CRRT group. No significant changes were observed in WBC and platelet counts after 1 week of treatment in either group. CONCLUSION: CRRT with the AN69ST membrane might have a beneficial effect on the consciousness level and inflammation of patients with stroke.
INTRODUCTION: Hemodialysis (HD) with low blood flow rate, continuous renal replacement therapy (CRRT), and peritoneal dialysis are recommended for patients with stroke complications to prevent intracranial hypertension because of the low diffusion capacity of the brain barrier. However, detailed guidelines are not currently available; thus, there is an urgent need to establish such guidelines. MATERIAL AND METHODS: We developed a novel protocol for performing CRRT with the AN69ST membrane, which has excellent adsorption capacity for various cytokines. The objective of this study was to compare the effect of the novel protocol with that of the current standard protocol, i.e. hemodialysis with low blood flow rate. To compare the effect of hemodialysis with low blood flow (HD group, n=27) and CRRT with AN69ST membrane (CRRT group, n=8), we measured the following consciousness and blood inflammatory parameters in patients with stroke complications at baseline and after 1 week of treatment: Glasgow Coma Scale (GCS) score, C-reactive protein (CRP) levels, and white blood cell (WBC) and platelet count. RESULTS: After 1 week, the total GCS score did not improve in the HD group, but improved significantly in the CRRT group (HD group: 13.1±3.0 to 13.3±3.1, p=0.5508, CRRT group: 8.9±3.9 to 11.5±3.9, p=0.0313). Improvement in the CRRT group was significantly higher than in the HD group (p=0.0039). CRP levels did not change significantly in either the HD (3.8±5.5 to 5.3±4.3 n.s.) or CRRT groups (7.7±10.0 to 3.7±3.2 n.s.); however, they tended to increase in the HD group and decrease in the CRRT group. No significant changes were observed in WBC and platelet counts after 1 week of treatment in either group. CONCLUSION: CRRT with the AN69ST membrane might have a beneficial effect on the consciousness level and inflammation of patients with stroke.
Authors: A I Burov; T A Abramov; N S Kostritca; D S Korotkov; G V Danilov; Y V Strunina; I A Savin Journal: Eur J Med Res Date: 2021-12-20 Impact factor: 2.175