Concerted range of products
Fresenius Medical Care offers a wide range of individual disposables, pre-assembled kits and further products for CKRT - and in particular Ci‑Ca therapy - as well as for complementary therapies, such as plasma exchange, adsorbers for cytokine or pathogen removal* and low-flow extracorporeal CO2 removal on the multiFiltratePRO.
All products are concerted to complement each other and facilitate easy delivery of effective treatments on the ICU.
*in selected countries
With our range of Ci‑Ca Dialysates, Ci‑Ca therapy can be tailored to the patients' needs. Ci‑Ca Dialysates are available in different potassium concentrations and with or without phosphate.
For more information on CKRT fluids available in your country, please contact your local Fresenius Medical Care representative.
Ultraflux AV filters in CKRT
The Ultraflux AV filters contain a Fresenius Polysulfone membrane specially developed for CKRT. This membrane enables the elimination of smaller molecules such as uremic toxins and creatinine while plasma proteins like albumin, bigger molecules and cellular blood constituents are effectively retained.
Fresenius Medical Care's CKRT filters offer a number of advantages:
- Appropriate for Ci‑Ca (RCA) and heparin anticoagulation
- Steam sterilized
- Up to 72 hours duration of use
- A choice of different surface areas is available: Ultraflux AV 400 S (0.7 m2), Ultraflux AV 600 S (1.4 m2) and Ultraflux AV 1000 S (1.8 m2)
Ultraflux EMiC 2 for the removal of middle molecules
In addition to the conventional goals of CKRT, such as the control of the fluid status and the correction of electrolyte abnormalities, an enhanced reduction of IL‑6, IL‑8 and myoglobin compared to Ultraflux AV 1000 S was shown with the use of a high‑permeability membrane compared to Ultraflux AV 1000 S.1,2
The high‑permeability hemofilter Ultraflux EMiC 2 is used in Ci‑Ca CVVHD treatments. It can improve the removal of middle molecules exceeding the molecular weight of commonly known small-sized uremic toxins such as urea and creatinine, while retaining albumin.1‑5
Ultraflux EMiC 2 at a glance:
- Increased clearance of middle molecules such as myoglobin or interleukin-62
- High middle molecule clearance throughout the CKRT for up to 72 hours3
- Steep sieving coefficient curve3 closely mimics the physiological renal function
- Substantially stable albumin levels1‑5
plasmaFlux for therapeutic plasma exchange
Our plasma filter plasmaFlux is used for indications such as autoimmune diseases, metabolic diseases, endogenous and exogenous intoxications.6
plasmaFlux separates the plasma from the blood cells through the Polysulfone membrane. plasmaFlux is a non-prefilled plasma filter. The surface layer inside of the Plasmasulfone capillary is surrounded and stabilized by a second homogeneous, fine-pored layer.The Polysulfone membrane enables substances to pass, including plasma proteins such as immunoglobulins (e.g. IgM of 940 kDa) and lipoproteins (e.g. LDL of 2500 kDa).
- Simplified setup due to dry delivery of plasmaFlux P1 dry and plasmaFlux P2 dry plasma filters
- Free passage of protein components even exceeding molecular weights of two million Dalton
- Retaining blood cells
Adsorbers complementing therapeutic options in case of infection and inflammation
An infection may result in sepsis, which is a "life-threatening organ dysfunction caused by a dysregulated host response to infection".7 Depending on the stage of this process, hemoperfusion using certain adsorbers may be considered.
CytoSorb* is an extracorporeal hemoperfusion adsorber which consists of porous polymerized beads18, providing a large surface area for adsorption.19 CytoSorb effectively targets various low- and middle-molecular-weight substances, while the bead’s pore size distribution limits the accessibility for larger substances as shown in vitro.18,19 CytoSorb is able to adsorb various cytokines, bilirubin and myoglobin, as blood passes through the device.18
In a retrospective, single-center study, propensity-adjusted mortality was lower with CytoSorb added to CKRT compared to a control group receiving CKRT only.20
Kit and solutions are available for the combination of CytoSorb therapy with multiFiltratePRO in CVVHD mode and multiFiltrate in CVVHD mode and hemoperfusion mode.
* Legal manufacturer of CytoSorb is CytoSorbents Corporation, USA. Fresenius Medical Care Deutschland GmbH is a distributor of CytoSorb products for Critical Care Medicine and Intensive Care Unit applications in Czech Republic, Finland and France.
CKRT treatments can be combined with various forms of organ support such as gas exchangers, with limited additional invasiveness.21 Low-flow ECCO2R target blood flows can be achieved by efficient CKRT dialysis catheters, providing ease of use for CKRT system users.22
Fresenius Medical Care offers with the multiECCO2R* a product for low-flow CO2 removal:
- Applicable for both multiFiltratePRO and multiFiltrate
- Gas exchanger placed downstream of the hemofilter, but upstream of air detector23
- Blood flow max. 500 ml/min if anticoagulation with heparin planned23
- Blood flow max. 200 ml/min if Ci‑Ca anticoagulation used
* Legal manufacturer of multiECCO2R is EUROSETS S.r.l., Italy. Fresenius Medical Care Deutschland GmbH is a distributor of multiECCO2R in selected countries.
All proVen care catheters are specially designed and manufactured for smooth and steady blood transport.
proVen care catheter sets are handcrafted premium products:
- Pediatric double lumen catheter sets
- Double lumen catheter sets
- High-flow double lumen catheter sets
They are manually assembled in a highly complex process comprising over 20 production steps.
The shaft of all proVen care catheters is made of thermosensitive polyurethane, which is rigid during insertion, but becomes soft and flexible at body temperature.
All clamps are fitted with a security insert for fast and reliable closure. They are color-coded to distinguish access and return lumen and indicate all relevant catheter parameters: volume, length and diameter.
1 Eichhorn T et al. Blood Purif 2017; 44(4);260‑266
2 Weidhase L et al. Crit Care 2020; 24(1):644
3 Siebeck M et al. Ther Apher Dial 2018; 22(4):355‑364
4 Schmidt JJ et al. Blood Purif 2012; 34:246‑252
5 Weidhase L et al. PLoS ONE 2019; 14:e0215823
6 Instruction for Use, plasmaFlux P1/P2 dry, valid from 05/2020
7 Singer M et al. JAMA 2016; 315:801‑810
8 Seraph 100 Microbind Affinity Blood Filter Instructions For Use: CP009 Rev C (12.2019)
9 Eden G et al. Crit Care 2022; 26:181
10 Chitty SA et al. Crit Care Explor 2022; 4(4):e0662
11 Schmidt JJ et al. Nephrol Dial Transplant 2022; 37(4):673-680
12 Mattsby-Baltzer I et al. J Microbiol Biotechnol 2011; 21(6):659‑664
13 Seffer M-T et al. BMJ Case Rep 2020; 13:e235262
14 Olson S W et al. Crit Care Explor 2020; 2:e0180
15 Kielstein JT et al. Crit Care 2021; 25(1):190
16 Seffer M-T et al. Blood Purif 2021; 50(1):28‑34
17 McCrea K et al. PLOS One 2014; 9(12):e114242
18 Instructions for use, CytoSorb 300 mL Device, Part #17-0071-14 Issued 07JUN2020
19 Ankawi G et al. Blood Purif 2019; 48:196‑202
20 Brouwer et al. Crit Care 2019; 23:317
21 Forster C et al. Crit Care 2013; 17:R154
22 Staudinger T. Perfusion 2020; 35:492-508
23 Instruction for use multiECCO2R, EU10306 - Rev. 04 2020/09/04