Doppler ultrasonic detection of particulate release during hemodialysis with cellulose hollow-fiber and sorbent suspension reciprocating dialyzers.

Doppler ultrasound is a noninvasive technique for monitoring moving objects such as flowing blood while ignoring stationary objects such as shunt tubing. A Doppler system was investigated to determine its sensitivity in detecting particulate release in blood during hemodialysis. Seven hemodialysis procedures with dogs and six trials with humans were done using a sorbent suspension reciprocating dialyzer ( SSRD ). Two additional trials were done with humans using a cellulose acetate hollow-fiber dialyzer (HFD). A large increase (approximately twofold) was found in the reflected Doppler signal in outflowing blood from the SSRD and HFD in both dogs and humans. Numerous additional studies to characterize the nature of the particulate matter showed platelet aggregates in the dogs and fibrinogen-fibrin degradation products in the humans to be present in the outflowing blood. In vitro studies suggested microscopic air bubbles (less than 25 micron in diameter) may have contributed to the particulate matter detected during hemodialysis by this sensitive monitoring system.