Studies on the Development of a New Method of Controlling the Amount and Contents of Body Fluids (Extra Corporeal Ultrafiltration Method: ECUM) and the Application of this Method for Patients Receiving Long Term Hemodialysis

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  • 血液透析患者に対する新しい体液管理法(Extra Corporeal Ultrafiltration Method: ECUM)の開発と応用に関する研究
  • ケツエキ トウセキ カンジャ ニ タイスル アタラシイ タイエキ カンリホウ Extra corporeal ultrafliltration method ECUM ノ カイハツ ト オウヨウ ニ カンスル ケンキュウ

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A new method of controlling body fluids in the patients receiving long term hemodialysis has been developed and has come to be applied clinically. This method we call Extra Corporeal Ultrafiltration Method (ECUM) was developed after extensive laboratory studies has produced excellent results. In this method using the standard Kiil dialyser, the dialysate outlet is closed and the inlet is connected to the suction pump. With negative pressure (200 mmHg), body fluids from the patients suffering from overhydration and congestive heart failure can be filtrated effectively. This method was used eighty one times in total on thirty one patients who were receiving long term hemodialysis and were unable to control their body fluids adequately. Before the treatment, the symptons of overhydration were observed in twenty patients. 500-1000 ml/hr, of ultrafiiltrate was removed from each patient by ECUM. The volume of filtrate varied according to the flow rate through the shunt, and the blood pressure of the patient, as well as to the rate of negative pressure in the pump during treatment. The volume varied also in proportion to the duration of the treatment. The concentrations of urea nitrogen, creatinine, uric acid, sodium, potassium and inorganic phos-phorus in the ultrafiltrate were the same as in the serum after the treatment and the concentrations of those in the serum before the treatmentwere also the same as after the treatment. The total protein filtered from the serum was very little, and the ultrafiltrate concentration ranges from 0 to 0.2 gm/dl. The concentration of calcium in thefiltrate was 70-80% of that in the serum. As side effects of ECUM, chills and fever were observed in six patients, abnormal thirst in two, and headache in one. There were no undesirable alternation in blood pressure and no abnormal findings in ECG during or after the treatment. The results of our studies suggest that ECUM might be a good method for controlling body fluids in the overhydrated patients. It could be also useful for the research on the many substances in the ultrafiltrate, and it may very well be applied to the research on the artificial kidney machines. Finally it could be helpful in the study of matters concerning uremia.

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