Using the seraph® 100 microbind® affinity blood filter under slow flow conditions through a normal central line

ABSTRACT

Background: The Seraph® 100 Microbind® Affinity blood filter has been in use since 2019 for the treatment of difficult to treat blood stream infections.and since 2020 for the treatment of critically ill COVID-19 patients. It is operated under blood flow rates of 100 -350 mL/min, which requires a large bore central line a dialysis catheter. The aim of our study was to evaluate to evaluate the usability of the Seraph® 100 under slow flow conditions through a normal central line (in clinical practice). Methods: A standard hemoperfusion blood tubing system as well as the Seraph® 100 (Exthera Medical, CA, USA) was used. Vascular access was a 20 cm trillumen central venous line (2 x 18 G and 1 x 16 G) that was inserted into a reservoir. The Multifiltrate (Fresenius Medical Care) was used to pump normal saline (n=5) or human plasma (n=5) through the Seraph® 100. Pressures were recored at any given flows (Qb). In two patients connected to a five lumen 20 cm catheter (Certofix Safety Quinto S1220, B. Braun, Melsungen, Germany -1 x 12 G, 1 x 16 G, 3 x 18 G) blood flow as well as arterial and venous pressure were recorded through the 24 h treatment. Results: Using saline or human plasma the Seraph® 100 Microbind®Affinity Blood Filter can be operatied at blood flow rates of up to 100 mL/min even through a 16 & 18 G lumen at tolerable arterial and venous pressures. In men using either the 12 G or the 16 G lumen as arterial line blood a blood flow rate of 50 mL/mon could be onbtained for 24 hours without problems. Conclusions: The Seraph® 100 Microbind®Affinity Blood Filter can be operated at blood flow rates of 50 mL/min even through 16 & 18 G catheters. Arterial and venous pressures depending on the flow (Qb) during hemoperfusion with the Seraph® 100 Microbind® Affinity Blood Filter.