Permeability decay in CAVH hemofilters

Change in hydraulic permeability over time was measured in four types of continuous arteriovenous hemofiltration (CAVH) hemofilters in order to characterize permeability decay and demonstrate that permeability decay occurs without membrane protein exposure. Polyamide, polysulfone, and polyacrylonitrile membrane hemofilters were placed in a gravity-driven in vitro CAVH apparatus. Distilled and deionized water or saline was used to perfuse the hemofilters. A biphasic pattern of permeability decay was seen in all hemofilter types. A large exponential decline in permeability occurred over the first 1 to 6 hours, with a more gradual decay thereafter. Of all membranes studied, polysulfone hemofilters were the most permeable upon initiation of use but showed the most pronounced early and late permeability decay. Both polyamide and polyacrylonitrile hemofilters showed little permeability decay after a brief exponential decay. These data suggest that early membrane hydraulic permeability decay may not be primarily due to membrane protein coating. Initial high permeability may place some CAVH systems at risk for hemofilter plugging.