Many AKI patients, especially those with sepsis, have impaired blood clotting capabilities and are at increased risk for serious bleeding. The use of systemic anticoagulation for CRRT in such patients can be very problematic.
The new Prismaflex eXeed™ system has two offerings for management of critically ill AKI patients, especially in the setting of sepsis -- septeX™ and oXiris™. These are proprietary disposable sets used only in conjunction with the Prismaflex system.
The base membrane comprising the filter in the oXiris set is AN69™, the most widely used CRRT membrane in the world. One unique AN69 property is its ability to remove compounds of interest by adsorption (membrane binding). The oXiris membrane has the ability to remove inflammatory mediators by this mechanism. Furthermore, due to specific modification of the membrane, one additional set of molecules targeted for adsorptive removal is related to endotoxin. These endotoxin fragments act as an inflammatory stimulus in many septic episodes. Finally, with consideration of the increased bleeding risk of the AKI population receiving CRRT, heparin is immobilized to the blood-contacting surface of the oXiris membrane.