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ID 115878
著者
Nishioka, Junji Tokushima University
Igata, Naoki Tokushima University
Komatsu, Takatoshi Tokushima University
Ohnishi, Yoshiaki Tokushima University
Fukuhara, Masashi Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers
Ishikawa, Masashi Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers
柴田, 啓志 Tokushima Prefectural Central Hospital
Shinomiya, Hirohiko Yoshinogawa Medical Center
Nakasono, Masahiko Tsurugi Municipal Handa Hospital
Kishi, Fumiko Tokushima Municipal Hospital
Komai, Keiko Takatori Corporation
Tatsuki, Yayoi Takatori Corporation
Murashima, Toru Takatori Corporation
Deguchi, Yoshihiro Takatori Corporation
Aramaki, Hiroshi Takatori Corporation
Fukumitsu, Hideyuki Takatori Corporation
キーワード
automatic ascites processing
cell-free and concentrated ascites reinfusion therapy
refractory ascites
資料タイプ
学術雑誌論文
抄録
Cell‐free and concentrated ascites reinfusion therapy (CART) is an effective therapy for refractory ascites. However, CART is difficult to perform as ascites filtration and concentration is a complicated procedure. Moreover, the procedure requires the constant assistance of a clinical engineer or/and the use of an expensive equipment for the multi‐purpose blood processing. Therefore, we developed a CART specialized equipment (mobility CART [M‐CART]) that could be used safely with various safety measures and automatic functions such as automatic washing of clogged filtration filter and self‐regulation of the concentration ratio. Downsizing, lightning of the weight, and automatic processing in M‐CART required the use of newly developed multi‐ring‐type roller pump units. This equipment was approved under Japanese regulations in 2018. In performing 41 sessions of CART (for malignant ascites, 22 sessions; and hepatic ascites, 19 sessions) using this equipment in 17 patients, no serious adverse event occurred. An average of 4494 g of ascites was collected and the total amount of ascites was processed in all the sessions without any trouble. The mean weight of the processed ascites was 560 g and the mean concentration ratio was 8.0. The ascites were processed at a flow rate of 50 mL/min. The mean ascites processing time was 112.5 minutes and a 106.5‐minutes (95.2%) ascites processing was performed automatically. The operator responded to alarms or support information 3.2 times on average (3.1 minutes, 2.1% of ascites processing time). Human errors related to ascites processing were detected by M‐CART at 0.4 times per session on average and were appropriately addressed by the operator. The frequencies of automatic washing of clogged filtration filter and self‐regulation of the concentration ratio were 31.7% and 53.7%, respectively. The mean recovery rates (recovery dose) of protein, albumin, and immunoglobulin G were 72.9%, 72.9%, and 71.2% (65.9 g, 34.9 g, and 13.2 g), respectively. Steroids were administered in 92.7% of the sessions to prevent fever and the mean increase in body temperature was 0.53°C. M‐CART is a compact and lightweight automatic CART specialized equipment that can safely and easily process a large quantity of ascites without the constant assistance of an operator.
掲載誌名
Artificial Organs
ISSN
15251594
cat書誌ID
AA00551950
出版者
International Center for Artificial Organs and Transplantation|Wiley
44
8
開始ページ
856
終了ページ
872
発行日
2020-03-18
権利情報
This is an open access article under the terms of the Creat ive Commo ns Attri bution License(https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
医学系
病院
理工学系