Blood Purification Therapy With Dual-cannula in Jugular-femoral Venous

Study Overview
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Brief Summary
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Acute kidney failure (AKI) is one of the most important causes of morbidity and mortality for critical ill patients. The use of blood purification treatment such as renal replacement therapy (CRRT) and plasma exchange has gradually developed into an effective treatment. However, the efficiency of blood purification may be affected by the recirculation of dual-lumen venous catheter for some special patients including patients with vena cava reflux disorder from massive occupations or ascites. For extreme cases like patients with vena cava disconnection or severe obstruction, the traditional blood purification treatment cannot work effectively. Thus, we used the dual-cannula in jugular-femoral venous blood purification therapy in the following two patients and found that it can improve the perfusion of systemic circulation and the prognosis of patients

Official Title
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Preliminary Study on the Effect of Blood Purification Therapy With Dual-cannula in Jugular-femoral Venous

Conditions
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Blood Purification, Dual-cannula, Vena Cava Disconnection

Intervention / Treatment
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* Device: Hemodialysis Catheter


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. patients requiring haemodilution therapy for various reasons (acute renal failure, acute liver failure, etc.) 2. presence of superior vena cava and/or inferior vena cava reflux disorders 3. age greater than 18 years Exclusion Criteria: 1. Inability to establish suitable vascular access 2. Pregnant women 3. Not agreeing to active life support treatment 4. Severe active bleeding

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: the treatment-as-usual group<br>we used the single-cannula in femoral venous blood purification therapy in the following patients with vena cava disconnection or severe obstruction | |
| Experimental: intervention group<br>we used the dual-cannula in jugular-femoral venous blood purification therapy in the following patients with vena cava disconnection or severe obstruction | Device: Hemodialysis Catheter<br>* We add a dialysis catheter to the patient, i.e., replace single-cannula in femoral venous with dual-cannula in jugular-femoral venous<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| vasoactive drugs | doses of vasoactive drugs | 144 hours after dual-cannula in jugular-femoral venous | 
| ICU mortality | Measurement of ICU mortality | 28-day ICU mortality | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cytokine | Checking cytokine levels by laboratory | 24hous after dual-cannula in jugular-femoral venous |