[It] enabled an effective treatment of acute renal failure and excellent control on the acid–base status as well on the systemic ionised calcium in combination with negligible clotting issues.2
|Supports the user with expert information and features|
|For routine adjustments of the Ci-Ca therapy, information from the protocol can easily be retrieved on the screen|
|In case of certain values set outside the standard range, the multiFiltratePRO makes the user aware of potentially risky clinical situations|
Clear allocation of functionality
Dedicated pumps for citrate and calcium keep the syringe pump available for heparin application if needed during Ci-Ca therapy. Separate level detectors and drip counters enable timely detection of empty bags, preventing air being transported downstream and enabling a smooth continuation of the treatment. During bag changes (dialysate, substituate, filtrate) the citrate infusion continues for a reliable period of time. This helps to avoid early coagulation of the system
Therapeutic Plasma Exchange is a well-established extracorporeal blood purification technique.
As described by Reeves et al., “the therapeutic effects of TPE could include the removal of pathological substances from the blood, such as monoclonal paraproteins and autoantibodies, as well as the replacement of deficient plasma components when plasma is used as a replacement fluid.”5
Indications for TPE cover selected diagnoses from different specialties:5
In contrast to separation via centrifugation, multiFiltratePRO separates the plasma from the blood cells via membrane plasma separation (MPS).
Touchscreen-based interface guides the nurse through the entire setup, rinsing and priming.
Key information on the screen
Pressure display, exchanged volume and target plasma volume, treatment time, flow rates and pressure history.
Integrated automated plasma volume calculation
The patient’s plasma volume and the respective plasma exchange volume can be calculated by the plasma calculator of the multiFiltratePRO, according to Sprenger et al.6
Substitution fluid holder
Placed on the upper scale tray, the substitution fluid holder allows for easy bottle and bag handling at eye-level.
Two integrated substitution fluid heater bags
Two integrated substitution fluid heater bags gently warm the substitution solution to curtail the cooling of the patient.
Automated ramp-up of plasma separation
The multiFiltratePRO features a plasma to blood ratio ramp-up procedure to provide for a smooth start of plasma separation and stable filtration conditions7, while saving the user time, see figure 1: Plasma to blood ratio ramp-up.
The multiFiltratePRO includes a graphic user interface that monitors and displays all relevant set-up and treatment data. The integrated alarm system helps to quickly determine the urgency as well as the root cause of alarms.
The time until the next expected user action is displayed in the status bar at the top right of the screen. In addition, a list of further upcoming user interactions can be retrieved on the screen. Both help to optimize work processes in the ICU.
The “Care Button” switches the multiFiltratePRO into care-mode, by decreasing the blood flow, stopping the balancing system and extending the pressure limits. This will prevent unnecessary alarms when moving the patient or manipulating the catheter.
1 KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney International Supplements 2012. 2:1-138.
2 Morgera S et al., A safe citrate anticoagulation protocol with variable treatment efficacy and excellent control of the acid-base status. Critical Care Medicine 2009. 37:2018-24.
3 Morgera S et al., Metabolic complications during regional citrate anticoagulation in continuous venovenous hemodialysis: single-center experience. Nephron Clinical Practice 2004. 97:c131-6.
4 Kalb R et al., Regional citrate anticoagulation for high volume continuous venovenous hemodialysis in surgical patients with high bleeding risk. Therapeutic Apheresis and Dialysis 2013. 17:202-12.
5 Reeves HM et al. The mechanisms of action of plasma exchange. British Journal of Haematology 2014;164(3):342-51.
6 Sprenger KB et al. Nomograms for the prediction of patient’s plasma volume in plasma exchange therapy from height, weight, and hematocrit. Journal of Clinical Apheresis 1987;3(3):185-90.
7 Malchesky PS Membrane processes for plasma separation and plasma fractionation: guiding principles for clinical use. Therapeutic Apheresis 2001;5(4):270–282.