The Effect of Continuous Renal Replacement Therapy on the Efficiency of Extracorporeal CO2 Removal

In the design of extracorporeal carbon dioxide removal (ECCO2R) combined with continuous renal replacement therapy (CRRT) equipment, in model of continuous veno-venous hemofiltration (CVVH) , the HCO3- concentration in the pre membrane lung blood is diluted by the replacement solution, and a decrease in HCO3- leads to a decrease in PCO2. On the other hand, in continuous veno-venous hemodialysis (CVVHD), HCO3- in post membrane blood will exchange interaction. The exchange results of HCO3- determine the impact of CVVHD on the CO2 removal efficiency of the ECCO2R combined CRRT system. This study aims to investigate the effects of CVVH and CVVHD on in vitro CO2 clearance efficiency.

Study Overview

• Status: Completed
• Conditions: Respiratory Failure With Hypercapnia
• Intervention / Treatment: Other: continuous renal replacement therapy

Detailed Description

In the design of extracorporeal carbon dioxide removal (ECCO2R) combined with continuous renal replacement therapy (CRRT) equipment, the pre dilution replacement solution for continuous veno-venous hemofiltration (CVVH) enters the extracorporeal bloodstream upstream of the membrane lung, so the HCO3- concentration in the pre membrane lung blood is diluted by the replacement solution. HCO3- and dissolved CO2 are in a dynamic and rapid equilibrium state, and a decrease in HCO3- leads to a decrease in PCO2. On the other hand, in continuous veno-venous hemodialysis (CVVHD), the blood after the membrane needs to undergo material exchange with the dialysate through a filter. The dialysate is usually HCO3- with normal plasma concentration, so HCO3- in post membrane blood will exchange interaction. The exchange results of HCO3- determine the impact of CVVHD on the CO2 removal efficiency of the ECCO2R combined CRRT system. This study aims to investigate the effects of CVVH and CVVHD on in vitro CO2 clearance efficiency.

• Study Type: Observational
• Enrollment (Actual): 10

Contacts and Locations

Study Locations

• China
  • Jiangsu
    • Nanjing, Jiangsu, China, 210009
      • Ling Liu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

using Extracorporeal carbon dioxide removal combined with continuous renal replacement therapy

Description

Inclusion Criteria:

• Using Extracorporeal carbon dioxide removal combined with continuous renal replacement therapy
• 18 years ≤ age ≤ 85 years;

Exclusion Criteria:

• Severe hemodynamic instability (increased dosage of vasoactive drugs or MAP ≤ 65mmHg within two hours);
• Severe electrolyte deficiency (including severe hyponatremia (blood sodium<130mmol/L) and hypokalemia (blood potassium<3.0mmol/L));
• Participate in other intervention studies within 30 days;
• Do not consent this research

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Extracorporeal carbon dioxide removal combined with continuous renal replacement therapy; extracorporeal carbon dioxide removal combined with continuous veno-venous hemofiltration or continuous veno-venous hemodialysis.CVVH and CVVHD set-up: predilution 30 ml/kg/h, dialysate dose 30 ml/kg/h, ultrafiltration rate was equal to the total rate of substitution fluid infusion.	Other: continuous renal replacement therapy; continuous veno-venous hemofiltration or continuous veno-venous hemodialysis set-up: predilution 30 ml/kg/h, dialysate dose 30 ml/kg/h, ultrafiltration rate was equal to the total rate of substitution fluid infusion

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
extracorporeal CO2 removal rate	extracorporeal CO2 removal rate was calculated as the difference of total CO2 content before membrane lung and after hemofilter, and normalized to an inlet PCO2 of 45 mmHg	after 30min of continuous renal replacement therapy

Collaborators and Investigators

• Sponsor: Southeast University, China
• Investigators: Study Director: Ling Liu, Zhongda Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 24, 2023
• Primary Completion (Actual): December 31, 2023
• Study Completion (Actual): December 31, 2025

Study Registration Dates

• First Submitted: July 31, 2023
• First Submitted That Met QC Criteria: August 5, 2023
• First Posted (Actual): August 14, 2023

Study Record Updates

• Last Update Posted (Actual): January 22, 2026
• Last Update Submitted That Met QC Criteria: January 19, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Respiration Disorders; Signs and Symptoms, Respiratory; Respiratory Insufficiency; Hypercapnia; Therapeutics; Surgical Procedures, Operative; Extracorporeal Circulation; Renal Replacement Therapy; Continuous Renal Replacement Therapy
• Other Study ID Numbers: 20230731

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No