Small animal dialysis machine

In the treatment of cat renal failure, in addition to medication and infusion, dialysis is also essential for detoxification in the body. Renal failure affects the filtration function of the kidney. If nutrients and toxins cannot be filtered out and transported into the body and excreted out of the body in time, further damage will be caused to the body. Dialysis is divided into two types: hemodialysis and peritoneal dialysis. A few years ago, peritoneal dialysis has been the preferred method of dialysis for renal failure. The main method is that with the continuous improvement of hemodialysis technology in recent years, hemodialysate has gradually been used in medical treatment.

1. Hemodialysis

Hemodialysis (HD) is the most effective renal replacement treatment for acute and chronic renal failure, oliguric or anuric nephropathy, etc. One of the methods, hemodialysis has become the most successful organ replacement treatment method in the field of human medicine, but it is still blank in animals. The purpose of renal replacement therapy is to remove uremic toxins from the blood circulation to prevent their accumulation in tissues. Hemodialysis introduces animal blood and dialysate to both sides of the artificial semipermeable membrane for reverse flow. Through diffusion, convection, Adsorption realizes the movement of solutes on both sides of the semipermeable membrane, and ultrafiltration realizes water removal.

Hemodialysis steps

After the animal wakes up from anesthesia, measure the blood pressure, select the appropriate extracorporeal circulation pipeline and artificial kidney according to the animal's body surface area, and perform Check the concentration of dialysate A and B.

Power-on self-test: turn on the water treatment switch and perform water treatment pre-flushing. Turn on the dialysis machine and perform machine self-checks as required.

Installation of hemodialysis pipeline: Check that the hemodialyzer and the outer packaging of the blood pipeline are not damaged, and then install them in sequence according to the blood flow direction of the extracorporeal circulation, so that one end is connected to the arterial end and the other end is connected to the venous end. connected. The dialysate pipelines are connected to the inlet and outlet of the dialysate chamber of the dialyzer respectively, and then the artery end section is embedded on the blood pump, and the venous air-catching chamber is fixed, with the venous end of the hemodialyzer facing up.

Pipeline pre-flushing: Start the hemodialysis machine and use physiological saline to clean the dialysis pipeline and dialyzer blood chamber gas. After normal saline treatment, closed circulation is performed, and finally preflush with heparin saline.

Before dialysis, measure the animal's basic coagulation function test, ACT: 108S, check the hemodialysis catheter, use a syringe to check the blood flow and inject the first dose of heparin, recheck the ACT value after 5 minutes to 262S, reaching After the ideal value, prepare to draw blood on the machine.

After dialysis, blood return operation: insert a sterile needle, adjust the blood flow to 2ml/min, turn off the blood pump, clamp the arterial end with a hemodialysis clamp, connect the arterial end to physiological saline, and open the blood Pump, use normal saline to return blood throughout the process, and then clamp the venous end. Use prepared sterile gauze, elastic bandage, etc. to wrap the surgical site.

2. Peritoneal dialysis

The operation is relatively simple, the cost is relatively low, and the efficacy is equally effective. Metabolic waste in the bodyToxins and excessive retained water are excreted from the body along with the waste dialysate. By replacing the dialysate intermittently, the purpose of rapidly removing toxins, correcting acidosis, dehydration and electrolyte imbalance can be achieved. In layman's terms, peritoneal dialysis is the process of injecting clean fluid into the abdominal cavity and removing the fluid containing toxins from the body. For patients with a cre of about 1000?mol/L before dialysis, after one dialysis session, the cre can quickly drop to about 400?mol/L. This can effectively ensure that azotemia is reduced and ion balance and acid-base are corrected before renal function is restored. Balance and replenish sufficient water, thereby reducing nephron necrosis and reducing animal mortality.

Peritoneal dialysis can be classified according to the way the dialysate flows and the duration of the dialysis cycle. During a dialysis period, the method in which dialysate continuously flows into the abdominal cavity from one catheter and is discharged from another catheter is called continuous dialysis (peritoneal perfusion). This technology is currently not commonly used due to operational difficulties and complex reuse of dialysate. After the dialysate is injected, it stays in the abdominal cavity for a period of time and then is discharged again, which is called intermittent dialysis. There is a time interval between each exchange process of intermittent dialysis, during which the dialysate is drained, so no dialysis occurs. During a short interval between removing the old dialysate and injecting new dialysate, there is always dialysate in the abdominal cavity for continuous dialysis. This method is called continuous dialysis. Dialysate that stays in the abdominal cavity for 4-10 hours is called "continuous ambulatory dialysis". The residence time of dialysate during "emergency continuous dialysis" is within 1 hour. The method of always retaining a part of the dialysate in the abdominal cavity, only a part of the dialysate being discharged, and periodically injecting fresh dialysate is called tidal peritoneal dialysis. This technology is considered to be a hybrid model of continuous dialysis and intermittent dialysis, and is more superior than the above two, but it has not been widely used in veterinary clinical practice.

There are two main difficulties in peritoneal dialysis operation:

The first point: the composition of the dialysate needs to be prepared according to different dialysis purposes;

The second point Two points: The most difficult thing is that due to the influence of the omentum during dialysis, it makes it difficult to pump fluid. Therefore, when aspirating liquid, be sure to avoid the influence of the greater omentum. This requires a certain amount of experience and will be very convenient to operate. If it is operated by a novice, it may be difficult to extract even 1/4 of the liquid.

Peritoneal dialysis complications

In dogs and cats undergoing peritoneal dialysis, hypoalbuminemia, peritonitis, catheter obstruction, or dialysate retention are the most common. complication. Most of these complications are controllable.

End of Dialysis Treatment

It is best to continue dialysis until kidney function returns to normal so that the animal can survive without dialysis. If the animal's renal function is insufficient to sustain life after weaning from dialysis treatment, euthanasia should be considered. After several days of treatment, even though the dialysis was going smoothly, the animal's quality of life had not improved to an acceptable level.Dialysis treatment should also be discontinued if the animal's biochemical parameters do not improve or if the clinical symptoms are not relieved despite a reduction in azotemia, and if there is uncontrollable peritonitis.