Contrast-Enhanced Ultrasonography as a Novel Method for the Dynamic Visualization of Blood Flow and Fiber Blockage in Dialyzers: A Feasibility Study

The capillary dialyzer represents the central element of the extracorporeal blood circuit of a therapy system for hemodialysis. The aim of this study was to assess the blood-flow characteristics of dialyzers with the help of modern ultrasound techniques. Five brand-new dialyzers (FX80 classix, Frese...

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Published inUltrasound in medicine & biology Vol. 46; no. 9; pp. 2265 - 2275
Main Authors Putz, Franz Josef, Jung, Ernst Michael, Putz, Christina, Banas, Miriam C., Bergler, Tobias, Vienken, Jörg, Banas, Bernhard
Format Journal Article
LanguageEnglish
Published England Elsevier Inc 01.09.2020
Subjects
Blood flow
Capillary blockage
Contrast-enhanced ultrasonography (CEUS)
Dialyzer
Hemodialysis
Parametric
Perfusion
Time-intensity curve
Capillary blockage
Dialyzer
Time-intensity curve
Hemodialysis
Perfusion
Parametric
Contrast-enhanced ultrasonography (CEUS)
Blood flow
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Summary:The capillary dialyzer represents the central element of the extracorporeal blood circuit of a therapy system for hemodialysis. The aim of this study was to assess the blood-flow characteristics of dialyzers with the help of modern ultrasound techniques. Five brand-new dialyzers (FX80 classix, Fresenius Medical Care, Bad Homburg, Germany) and five dialyzers after a dialysis session were analyzed by different ultrasound techniques to detect functional and structural changes. B-mode and Doppler techniques were not suitable to describe differences in brand-new and clinically applied dialyzers. Contrast-enhanced ultrasonography, however, was able to visualize blood-flow profiles in the capillaries. Although dialyzers displayed no signs of clinical dysfunction, contrast-enhanced ultrasonography was able to detect blocked capillaries of varying degrees after a dialysis session in all five examined dialyzers. Consequently, the blood-flow velocity was higher in the remaining unblocked capillaries in comparison to the velocity in the brand-new dialyzers. This information may be helpful for improving the geometric design of dialyzers, including their capillary membranes, and optimizing anti-coagulation strategies in hemodialysis patients.
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ISSN:0301-5629
1879-291X
DOI:10.1016/j.ultrasmedbio.2020.05.005