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Discussion

CRRT question

We have just recently purchased PrismaFlex (made by Gambro) CRRT machines to replace our prior - outdated - Prisma machines. My only experience in caring for CRRT patients has been using the M60 or M100 hemofilters. Gambro has an HF series hemofilter which can be used with their PrismaFlex machines. I know the M series of filters have charged membranes and (theoretically) remove larger molecules - like sepsis mediators - more effectively by adsorption. I have never used the HF series and don't have the experiential knowledge to know if there are advantages/disadvantages compared to the M series.

Have any of you used both types of hemofilter? I've seen patients improve hemodynamically within the first hour or two of being on an M100 filter. I'd hate for us to lose that by choosing the HF series as we start using our new machines. I'd love to hear some bedside observations and be able to relay them as we make our own decisions (with the nephrologists, of course).

Thanks!

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We rarely use M60s where I work. The only time they use them is on the little tiny people that weigh around 90-100 lbs. Generally we use M100 or HF1000s. The bigger the filter, the longer they usually last before clotting. One of the problems with the HF1000s is that they do have more blood outside of the body at one time (I think it is over 160ml). We still have the older prisma machines... I guess we are supposed to be getting the new machines soon, but they have been saying that for over a year.

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