appendix 1c - rexeed powerpoint · dialyzer flexible receiver coil dialysate & blood pumps mr...
TRANSCRIPT
![Page 1: Appendix 1C - REXEED PowerPoint · Dialyzer Flexible receiver coil Dialysate & Blood pumps MR Imager receiver coil dG-DTPA: Contrast Agent Wooden Support frame Proof of Good Flow](https://reader033.vdocuments.net/reader033/viewer/2022042811/5f51dfd228fab7330e44a712/html5/thumbnails/1.jpg)
REXEEDREXEEDAchieving a new level of comprehensive
dialyzer performance
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The Features of REXEED
The new Membrane REXBRANE and new JACKETenable the best and comprehensive Performance
by Uniform Dialysate Flow Distributionwith Patient friendly Features
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REXEED Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Comprehensive Performance
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A Combination of new Jacket and REXBRANE
gives the uniform FlowUniform Dialysate Flow Distributiongives great Clearance Performance
REXBRANE
Waved Fiber
Proprietary Biocompatibility
Small Priming Volume
The largest PS ever-2.5 m2
New JacketFull Baffle
Short Taper Structure
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Totally New Jacket DesignPC Simulation-1: Effect of Full Baffle
APS REXEED
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Short Taper Optimizationby Comp. Simulation
long and gradual taper
polyurethane
Baffle panel partially surrounding bundle
short & sharp taper
polyurethane
Baffle panel wholly surrounding bundle
Straight Bigger
Header
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Uniform Dialysate DistributionUniform Dialysate Distribution
DialysateDialysate
Homogenenousdialysate distribution
DialysateDialysate
Uneven dialysate distribution
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Impact of Dialysate Flow Distribution on Blood Return (Image)
Un-uniform PressureUniform Pressure
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Ideal Pressure Image inside of Jacket
Pressure Distribution
Blood Side P1≒P2
Dialysate P3≒P4
Dialysate
Housing
P1 P2
P3 P4
Fiber
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Demonstration of Dialysate Uniform Flow<Dye Analysis>>>>
Fractionated by each ca. 10ml
QD=500ml/min
IncubatorBPB sol.
Each fraction was analyzed for BPB Absorbance
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0.00
0.05
0.10
0.15
0.20
0.25
0.30
0.35
0.40
0 10 20 30 40 50
Number of exhaust fractions (-)
Abs.(-)590nm
REXEED-15A(199.6)
OPTIFLUX 200NR (199.2)
Polyflux-21R(191.0)
Demonstration of DialysateUniform Flow
REXEED-15
○○○○ Ideal
×××× Broad
×××× Tailing
「「「「Time Course of Absorbance of Dye」」」」
Qb=200mL, QD=500mL/min
Others
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Dialyzer
Flexible receiver coil
Dialysate & Blood pumps
MR Imager
receiver coil
dG-DTPA:
Contrast Agent
Wooden Support frame
Proof of Good Flow Distribution-2
- Visualization of Dialysate Flow by MRI -
2005
ASN
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◎◎◎◎ Quick and complete Penetration X No Dialysate Penetration
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REXEED-15 FX80
FC1 HTrReXeed
Qb=200/Qd=500 ml/min
Average Speed of Dialysate Flow
In MRI
FPX-180
Qb=200/Qd=500 ml/min
0
5
10
15
20
25
30
35
40
45
50
-20 -15 -10 -5 0 5 10 15 20
Radius (mm)
Sp
eed
(m
m/s
)
Sagittal
2005 ASN TH-PO629
Radius (mm)
0
5
10
15
20
25
30
35
40
45
50
-20 -15 -10 -5 0 5 10 15 20
Sp
eed
(m
m/s
)
Sagittal
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REXEED Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Total Performance
Ultimate Small MW Clearance and
Comprehensive Performance
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Waved Fibers
JA Nagano Koseiren Shinonoi General Hospital
The 20th Congress for High Performance Membrane, ‘05
Waved Fibers make the most of Polysulfone Membrane
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REXBRANE: A New Waved FiberDesigned to maximize the Performance
in conjunction with new Jacket Structure
APS-S:Straight Φ200μm
REXEED-A:Waved
Φ185μm
Fresenius FX
Fresenius Optiflux
Fresenius F-HPS PS-UW
Polyflux 21RPolyflux 21RPolyflux 21RPolyflux 21R
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Expectation
1. Uniform Blood Return
2. Less residual Blood
3. Higher SM Clearance
4. Uniform Performance
Conventional REXEED
Uniform Pressure Balance Imagefor Blood and Dialysate
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REXEED Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Total Performance
Ultimate Small MW Clearance and
Comprehensive Performance
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In Vitro Performance of REXEEDIn Vitro Performance of REXEED--2525and other Dialyzersand other Dialyzers
REXEED-25
Optiflux 200NR
EXELTRA-210 Plus
ββββ2MG Clearance (mL/min)
Urea Clearance(mL/min)
Alb S.C. 0.010
50
125
0.033330000
0.020
400
350
375
100
75
(in vitro, bovine plasma, Qb=400mL/min. Qd=800mL/min. Qf=17, 20, 25mL/min)
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REXEED-S PERFORMANCEmanufacturer’s published data
UREA CLEARANCE
260
265
270
275
280
285
290
REXE
ED 2
5SRE
XEED
21S
Polyflu
x 21
0HRE
XEED
18S
Opt
iflux
F20
0NR
Opt
iflux
F18
0NR
REXE
ED 1
5SPo
lyflu
x 17
0HOpt
iflux
F16
0NR
Polyflu
x 14
0H
Flow Rates Qb 300/Qd 500 (mL/min)
Clearance (mL/min)
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REXEED-A Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Total Performance
Ultimate Small MW Clearance and
Comprehensive Performance
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Priming Volumes
unit::::mmmm
llll
1. Less Priming Volume with same Surface Area
2. Larger Surface Area with NO Priming Volume Increase
81-90
91-100
101-110
111-120
121-130
130<
1.5 1.6 1.7 1.8 1.9 2.0 2.1 2.4 2.5
REXEED 82 95 112 128
Optiflux-NR 83 112
Polyflux-R 121 152 165
Polyflux-H 115 125
Exeltra 95 105 115
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REXEED-A Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Total Performance
Ultimate Small MW Clearance and
Comprehensive Performance
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Excellent Biocompatibility of Asahi’s PS
W BC406080
1001201400 60 120 180 240Dialysis Duration (m in)Changed Ratio
(%) APS-15SAA社 PS膜B社 PS膜 C 3a50150250350450550
0 60 120 180 240Dialysis Duration (m in)Changed Ratio (%) APS-15SAA社 PS膜B社 PS膜WBC C3a
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Technical Aspects of REXEEDTechnical Aspects of REXEED
Clinical ExperienceClinical Experience
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Clinical Evaluation of Clinical Evaluation of
REXEEDREXEED--15 and PES15 and PESQb=200mL/minQd=500mL/min
0
20
40
60
80
BUN Crea UA iP β2-MG
********
0
2
4
6
****
Alb
Reduction rate (%)
Albumin loss (g/session)(11,800)
REXEED-15 PES
membrane surface area 1.5m2
Kushiro Urology Clinic
The 20th Congress for High Performance Membrane, ‘05
n=4 4hr
* P<0.05**P<0.005
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Clinical Evaluation of Clinical Evaluation of
REXEEDREXEED--25 and FB25 and FB--250F250F
0
10
20
30
40
50
60
70
80
UN Crea UA IP β2-MG α1-MG
0.0
0.5
1.0
1.5
2.0
(11,800) (33,000)
Albumin
Reduction rate (%)
Kidney Center, Shirasagi Hospital
The 20th Congress for High Performance Membrane, ‘05Albumin loss (g/session)
Qb=200mL/minQd=500mL/min
REXEED-25 CTA (2.5m2)
Average weight of dialysis patients 75.8±±±±17.6Kg nnnn=8
4hrs
*** **
*** P<0.0001** P<0.01
Mean±SD
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63.0
53.6
68.1
79.5
70.7
55.9
69.1
80.2
0 20 40 60 80 100
Urée
Créatinine
Phosphore
b2m
% Removal Rate
FX 60 Rexeed 15
n=10, Qb=300 Qd=500
France - Cabestany
FX 60 REXEED-15A
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Minimum Heparin Requirement (Average)
Saitama School of Medicine
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Complications and possible Causes to Dialyzers
REXEED will Help the Pts by
well Balanced SMW Permeability and Biocompatibility
Solute PermeabilitySolute Permeability
BiocompatibilityBiocompatibility
Dialysis-related Amyloidosis
Numbness Fatigue Hypotension
Swelling Pain Hypertension
Gout Anemia Arrhythmia
Headache Itch Coughing